EP3458084B1 - Für den glucagonrezeptor selektive polypeptide und verfahren zu deren verwendung - Google Patents

Für den glucagonrezeptor selektive polypeptide und verfahren zu deren verwendung Download PDF

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EP3458084B1
EP3458084B1 EP17725143.6A EP17725143A EP3458084B1 EP 3458084 B1 EP3458084 B1 EP 3458084B1 EP 17725143 A EP17725143 A EP 17725143A EP 3458084 B1 EP3458084 B1 EP 3458084B1
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seq
compound
aib
amino acid
isolated polypeptide
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EP3458084A1 (de
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William Blackwell
Ved P. SRIVASTAVA
Mark A. PAULIK
Andrew Young
Steven Thomas Dock
Iii Robert Neil Hunter
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Intarcia Therapeutics Inc
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Intarcia Therapeutics Inc
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    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
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    • A—HUMAN NECESSITIES
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    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
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    • A61M5/145—Pressure infusion, e.g. using pumps using pressurised reservoirs, e.g. pressurised by means of pistons
    • A61M2005/14513—Pressure infusion, e.g. using pumps using pressurised reservoirs, e.g. pressurised by means of pistons with secondary fluid driving or regulating the infusion
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Definitions

  • This invention relates to isolated polypeptides that are glucagon-receptor selective analogs and peptide derivatives thereof. These analogs and peptide derivatives have improved solubility, thermal stability, and physicochemical properties as compared to native endogenous glucagon. This invention also relates to methods of using such polypeptides in a variety of therapeutic and diagnostic indications, as well as methods of producing such polypeptides. These analogs are useful in methods of treating obesity, diabetes, metabolic disorders, and other diseases or disorders.
  • Glucagon a peptide hormone produced by the alpha cells of the pancreas, and glucagon-like peptide-1 (GLP-1), a neuropeptide, are derived from pre-proglucagon, a 158 amino acid precursor polypeptide that is processed in different tissues to form a number of different proglucagon-derived peptides.
  • proglucagon-derived peptides which include, for example, glucagon, GLP-1, glucagon-like peptide-2 (GLP-2), and oxyntomodulin (OXM), are involved in a wide variety of physiological functions, including glucose homeostasis, insulin secretion, gastric emptying, and intestinal growth, as well as the regulation of food intake.
  • Glucagon is a 29 amino acid peptide hormone that is produced by alpha cells in the pancreas and that interacts with the glucagon receptor ("GCGR").
  • GCGR glucagon receptor
  • an isolated polypeptide of the disclosure is a glucagon analog that binds to a glucagon receptor (GCGR) and is a selective glucagon receptor agonist.
  • GCGR glucagon receptor
  • These isolated polypeptides of the disclosure are potent, stable, and soluble.
  • the isolated polypeptides selectively bind the glucagon receptor as compared to native glucagon, for example, human glucagon, and as compared to the ability to bind to the GLP-1 receptor.
  • the isolated polypeptides exhibit improved metabolic stability and clearance of the drug from the kidney at a rate close to glomerular filtration rate verses native glucagon, e.g., human glucagon.
  • the isolated polypeptides exhibit an improved solubility as compared to native glucagon, for example, human glucagon. In preferred embodiments, the isolated polypeptides exhibit an improved solubility of at least 200 mg/ml. The isolated polypeptides exhibit an improved chemical stability at room temperature and at higher temperatures such as 37 °C or greater.
  • the isolated polypeptides of the disclosure are derived from a genus that imparts selectivity, solubility, and improved clearance of the molecule from the kidney. This genus is based on (a) a determination of the critical structure required for selectivity on the glucagon receptor, (b) the identification of critical amino acids and secondary structure motifs that provide for improved solubility while enhancing or at least maintaining the potency of human glucagon, and (c) the identification of amino acid substitutions for imparting chemical stability to the selective glucagon receptor agonists.
  • an isolated polypeptide of the disclosure comprises a modified amino acid sequence based on the amino acid sequence of human glucagon: HSQGTFTSDYSKYLDSRRAQDFVQWLMNT-OH (SEQ ID NO: 140), where the modified amino acid sequence includes at least one amino acid substitution, at least two amino acid substitutions, at least three amino acid substitutions, at least four amino acid substitutions, at least five amino acid substitutions, at least six amino acid substitutions, at least seven amino acid substitutions, at least eight amino acid substitutions, at least nine amino acid substitutions, at least 10 amino acid substitutions, at least 11 amino acid substitutions, at least 12 amino acid substitutions, at least 13 amino acid substitutions, at least 14 amino acid substitutions, at least 15 amino acid substitutions, at least 16 amino acid substitutions, at least 17 amino acid substitutions, at least 18 amino acid substitutions, at least 19 amino acid substitutions, at least 20 amino acid substitutions, at least 21 amino acid substitutions, at least 22 amino acid substitutions, at least 23 amino acid substitutions, at least
  • an isolated polypeptide of the disclosure comprises a modified amino acid sequence based on the amino acid sequence of human glucagon: HSQGTFTSDYSKYLDSRRAQDFVQWLMNT-OH (SEQ ID NO: 140), where the modified amino acid sequence includes at least one amino acid substitution, at least two amino acid substitutions, at least three amino acid substitutions, at least four amino acid substitutions, at least five amino acid substitutions, at least six amino acid substitutions, at least seven amino acid substitutions, at least eight amino acid substitutions, at least nine amino acid substitutions, at least 10 amino acid substitutions, at least 11 amino acid substitutions, at least 12 amino acid substitutions, at least 13 amino acid substitutions, at least 14 amino acid substitutions, at least 15 amino acid substitutions, or at least 16 amino acid substitutions, wherein the amino acid substitution(s) is selected from the group consisting of:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 1: X 1 X 2 X 3 GTFTSDX 10 X 11 X 12 X 13 LX 15 X 16 X 17 X 18 AQEFX 23 X 24 X 25 LEDE-Z-tail-(OH/NH 2 ) (SEQ ID NO: 1), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 2: X 1 X 2 X 3 GTFTSDX 10 X 11 X 12 X 13 LX 15 X 16 X 17 X 18 AQEFVX 24 WLEDE-Z-tail-(OH/NH 2 ) (SEQ ID NO: 2), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 3: YSX 3 GTFTSDYSKYLDX 16 X 17 X 18 AQEFVX 24 WLEDE-Z-tail-(OH/NH 2 ) (SEQ ID NO: 3), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 41). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 42). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 43).
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 44). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 45). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 46).
  • an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 41). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 42). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 43).
  • an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 44). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 45). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 46).
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDAARAQEFVKWLEDEPSSGAPPPS-OH (SEQ ID NO: 143), which is also referred to herein as Compound A97.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYTRLLESKRAQEFVKWLEDEPSSGAPPPS-OH (SEQ ID NO: 144), which is also referred to herein as Compound A98.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 145), which is also referred to herein as Compound A99.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDE-OH (SEQ ID NO: 146), which is also referred to herein as Compound A100.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YGHGTFTSDHSKYLD(Aib)KRAQEFVKWLEDE-OH (SEQ ID NO: 147), which is also referred to herein as Compound A101.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKWLD(Aib)KRAQEFVKWLEDE-OH (SEQ ID NO: 148), which is also referred to herein as Compound A102.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)ARAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 149), which is also referred to herein as Compound A103.
  • the polypeptide consists of an amino acid sequence selected from the group consisting of SEQ ID NOs: 143-149.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 137: YSQGTFTSDYSKYLDSX 17 RAQX 21 FVX 24 WLX 27 X 28 T-OH(SEQ ID NO: 137), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of YSQGTFTSDYSKYLDSK*RAQE*FVK**WLDE**T-OH (SEQ ID NO: 138), referred to herein as Compound A104 and YSQGTFTSDYSKYLDSK*RAQE*FVK**WLQE**T-OH (SEQ ID NO: 139), referred to herein as Compound A105.
  • the polypeptide consists of an amino acid sequence selected from the group consisting of SEQ ID NOs: 138 and 139.
  • the isolated polypeptides of the disclosure contain amino acid motifs that allow for maintaining characteristics such as solubility, and/or stability, e.g., metabolic stability, of the glucagon-receptor selective analogs as compared to the native human glucagon molecule, as well as amino acid motifs that allow for maintaining additional characteristics such as glucagon selectivity over GLP-1.
  • the C-terminus of the isolated polypeptide of the disclosure is extended with a sequence that binds to serum albumin, for example, to human serum albumin.
  • the C-terminus of the isolated polypeptide of the disclosure is extended with a sequence selected from the group consisting of EEPSSGAPPPS-OH (SEQ ID NO: 4); EPSSGAPPPS-OH (SEQ ID NO: 5); GAPPPS-OH (SEQ ID NO: 6); GGPSSGAPPPS-OH (SEQ ID NO: 7); GPSSGAPPPS-OH (SEQ ID NO: 8); KRNKNPPPS-OH (SEQ ID NO: 9); KRNKNPPS-OH (SEQ ID NO: 10); KRNKPPIA-OH (SEQ ID NO: 11); KRNKPPPA-OH (SEQ ID NO: 150); KRNKPPPS-OH (SEQ ID NO: 12); KSSGKPPPS-OH (SEQ ID NO: 13); PESGAPPPS-OH (SEQ ID NO: 14);
  • the carboxyl group of the C-terminal amino acid residue of an isolated polypeptide of the disclosure is amidated. In some embodiments, the carboxyl group of the C-terminal amino acid residue of an isolated polypeptide of the disclosure unmodified.
  • an isolated polypeptide provided herein is an agonist of glucagon activity. In some embodiments, an isolated polypeptide provided herein can bind to a glucagon receptor. In some embodiments, the glucagon receptor is a human glucagon receptor. In some embodiments, the isolated polypeptide of the disclosure binds to a human glucagon receptor with a pEC50 in the cAMP assay using an 11 point curve starting at 1 nM to 500 micromolar range (as described herein) in the range of greater than about 9.0.
  • the isolated polypeptide of the disclosure binds to a human glucagon receptor with a pEC50 in the cAMP assay using an 11 point curve starting at 1 nM to 500 micromolar range (as described herein) in the range of greater than about 11.0.
  • an isolated polypeptide of the disclosure binds to a human glucagon receptor, but does not substantially bind to a human GLP-1 receptor.
  • the term "does not substantially bind” and variations thereof refer to polypeptides that exhibit low affinity to no affinity for a human GLP-1 receptor.
  • an isolated polypeptide of the disclosure binds to a human glucagon receptor at an affinity that is at least 100-fold greater than the affinity of the same isolated polypeptide for a human GLP-1 receptor.
  • an isolated polypeptide of the disclosure binds to a human glucagon receptor at an affinity that is at least 1,000-fold greater than the affinity of the same isolated polypeptide for a human GLP-1 receptor.
  • the isolated polypeptide of the disclosure binds to a human glucagon receptor with a pEC50 in the cAMP assay using an 11 point curve starting at 1 nM to 500 micromolar range in the range of greater than about 9.0, and the isolated polypeptide of the disclosure binds to human GLP-1 receptor with a pEC50 in the cAMP assay that is less than about 10.0.
  • the isolated polypeptide of the disclosure binds to a human glucagon receptor with a pEC50 in the cAMP assay using an 11 point curve starting at 1 nM to 500 micromolar range in the range of greater than about 11.0, and the isolated polypeptide of the disclosure binds to human GLP-1 receptor with a pEC50 in the cAMP assay that is less than about 9.0.
  • an isolated polypeptide as provided herein can further comprise a heterologous moiety associated with the polypeptide.
  • the heterologous moiety is a protein, a peptide, a protein domain, a linker, an organic polymer, an inorganic polymer, a polyethylene glycol (PEG), biotin, an albumin, a human serum albumin (HSA), a HSA FcRn binding portion, an antibody, a domain of an antibody, an antibody fragment, a single chain antibody, a domain antibody, an albumin binding domain, an enzyme, a ligand, a receptor, a binding peptide, a non-FnIII scaffold, an epitope tag, a recombinant polypeptide polymer, a cytokine, or any combination of two or more of such moieties.
  • the isolated polypeptides provided herein exhibit glucagon receptor agonistic activity, for example by binding a glucagon receptor.
  • the isolated polypeptides provided herein completely or partially agonize or otherwise stimulate glucagon activity upon binding to or otherwise interacting with a glucagon receptor.
  • the stimulation or modulation of a biological function of glucagon is complete or partial upon interaction between the glucagon receptor agonist and the glucagon receptor.
  • the second agent is a polypeptide.
  • the second polypeptide is an insulinotrophic peptide.
  • the insulinotrophic polypeptide is selected from the group consisting of exenatide, a derivative of exenatide, an analogue of exenatide, glucagon-like peptide-1 (GLP-1), a derivative of GLP-1, and an analogue of GLP-1.
  • the insulinotrophic polypeptide is exenatide, a derivative of exenatide, or an analog of exenatide.
  • the exenatide is synthetic exenatide.
  • the synthetic exenatide comprises the amino acid sequence H-His-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile-Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH 2 (SEQ ID NO: 142).
  • glucagon/GLP-1 agonism i.e ., weight-loss, increase in energy expenditure
  • an isolated polypeptide as provided herein and the additional agent are formulated into a single therapeutic composition, and the isolated polypeptide and additional agent are administered simultaneously.
  • the isolated polypeptide and additional agent are separate from each other, e.g ., each is formulated into a separate therapeutic composition, and the isolated polypeptide and the additional agent are administered simultaneously, or the isolated polypeptide and the additional agent are administered at different times during a treatment regimen.
  • the isolated polypeptide is administered prior to the administration of the additional agent, the isolated polypeptide is administered subsequent to the administration of the additional agent, or the isolated polypeptide and the additional agent are administered in an alternating fashion.
  • the isolated polypeptide and additional agent are administered in single doses or in multiple doses.
  • the disease or condition is type 2 diabetes mellitus.
  • Also provided herein are methods of treating, preventing, delaying the onset of, delaying the progression of, and/or otherwise ameliorating a symptom of a disease or disorder in which agonism at the glucagon receptor is desired such as, by way of nonlimiting example, chronic pain, hemophilia and other blood disorders, endocrine disorders, metabolic disorders, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), Alzheimer's disease, cardiovascular diseases, hypoglycemia unawareness, restrictive lung disease, chronic obstructive pulmonary disease, lipoatrophy, metabolic syndrome, leukemia, hepatitis, renal failure, autoimmune diseases (e.g., Grave's disease, systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis), shock and/or wasting disorders, pancreatitis, and neurological disorders and diseases such as Parkinson's disease.
  • autoimmune diseases e.g., Grave's disease, systemic
  • the isolated polypeptides of the disclosure and/or pharmaceutical compositions described herein are administered alone or in combination with pharmaceutically acceptable carriers and/or excipients and/or polymers and/or organic solvent, in either single or multiple doses.
  • compositions can include a polypeptide of the disclosure, along with a suitable carrier. These pharmaceutical compositions can be included in kits, such as, for example, diagnostic kits.
  • This invention relates to isolated polypeptides that are glucagon-receptor selective analogs and peptide derivatives thereof.
  • Glucagon is produced by the pancreas and interacts with the glucagon receptor ("GCGR").
  • GCGR glucagon receptor
  • an isolated polypeptide of the disclosure is a selective glucagon receptor agonist.
  • an isolated polypeptide of the disclosure binds to a glucagon receptor.
  • the term "about” is understood as within a range of normal tolerance in the art, for example within 2 standard deviations of the mean. About can be understood as within 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.1%, 0.05%, or 0.01% of the stated value. Unless otherwise clear from the context, all numerical values provided herein are modified by the term "about.”
  • the term “substantially” is understood as within a narrow range of variation or otherwise normal tolerance in the art. Substantially can be understood as within 5%, 4%, 3%, 2%, 1%, 0.5%, 0.1%, 0.05%0, 0.01%0 or 0.001% of the stated value.
  • drug refers to any therapeutically active substance that is delivered to a subject to produce a desired beneficial effect.
  • the drug is a polypeptide.
  • the drug is a small molecule, for example, hormones such as androgens or estrogens.
  • the devices and methods of the present invention are well suited for the delivery of proteins, small molecules and combinations thereof.
  • peptide typically refers to a molecule comprising a chain of two or more amino acids (e.g., most typically L-amino acids, but also including, e.g., D-amino acids, modified amino acids, amino acid analogs, and amino acid mimetic).
  • Peptides may be naturally occurring, synthetically produced, or recombinantly expressed. Peptides may also comprise additional groups modifying the amino acid chain, for example, functional groups added via post-translational modification.
  • post-translation modifications include, but are not limited to, acetylation, alkylation (including, methylation), biotinylation, glutamylation, glycylation, glycosylation, isoprenylation, lipoylation, phosphopantetheinylation, phosphorylation, selenation, and C-terminal amidation.
  • the term peptide also includes peptides comprising modifications of the amino terminus and/or the carboxy terminus. Modifications of the terminal amino group include, but are not limited to, des-amino, N-lower alkyl, N-di-lower alkyl, and N-acyl modifications.
  • Modifications of the terminal carboxy group include, but are not limited to, amide, lower alkyl amide, dialkyl amide, and lower alkyl ester modifications (e.g ., wherein lower alkyl is C 1 -C 4 alkyl).
  • the term peptide also includes modifications, such as but not limited to those described above, of amino acids falling between the amino and carboxy termini.
  • a peptide may be modified by addition of a small-molecule drug.
  • the terminal amino acid at one end of the peptide chain typically has a free amino group (i.e ., the amino terminus).
  • the terminal amino acid at the other end of the chain typically has a free carboxyl group (i.e ., the carboxy terminus).
  • the amino acids making up a peptide are numbered in order, starting at the amino terminus and increasing in the direction of the carboxy terminus of the peptide.
  • amino acid residue refers to an amino acid that is incorporated into a peptide by an amide bond or an amide bond mimetic.
  • insulinotrophic typically refers to the ability of a compound, e.g ., a peptide, to stimulate or affect the production and/or activity of insulin (e.g., an insulinotrophic hormone). Such compounds typically stimulate or otherwise affect the secretion or biosynthesis of insulin in a subject.
  • an "insulinotrophic peptide” is an amino acid-containing molecule capable of stimulating or otherwise affecting secretion or biosynthesis of insulin.
  • insulinotrophic peptide as used herein includes, but is not limited to, glucagon-like peptide 1 (GLP-1), as well as derivatives and analogues thereof, exenatide, exenatide having the amino acid sequence of SEQ ID NO; 1, as well as derivatives and analogues thereof.
  • GLP-1 glucagon-like peptide 1
  • exenatide exenatide having the amino acid sequence of SEQ ID NO; 1, as well as derivatives and analogues thereof.
  • cretin mimetics includes, but is not limited to GLP-1 peptide, peptide derivatives of GLP-1, peptide analogs of GLP-1; exenatide, exenatide having the amino acid sequence of SEQ ID NO: 1, exenatide peptide, peptide derivatives of exenatide, and peptide analogs of exenatide.
  • Examples of preferred incretin mimetics include exenatide, exenatide having the amino acid sequence of exendin-4 (the naturally-occurring form of exenatide, and has the amino acid sequence of SEQ ID NO: 1), exenatide-LAR, lixisenatide, GLP-1 (7-36), liraglutide, semaglutide, dulaglutide, albiglutide, and taspoglutide.
  • Incretin mimetics are also referred to herein as "insulinotrophic peptides.” Incretin mimetics which target the GLP-1 receptor are also known in the literature as"GLP-1 receptor agonists.”
  • an exenatide as used herein includes, but is not limited to exenatide, exenatide having the amino acid sequence of SEQ ID NO: 1, native exendin-4, exenatide peptides, exenatide peptide analogs, and exenatide peptide derivatives.
  • GLP-1 refers to a polypeptide that is produced by the L-cell located mainly in the ileum and colon, and to a lesser extent by L-cells in the duodenum and jejunum.
  • GLP-1 is a regulatory peptides to a G-coupled protein receptor on ⁇ cell and via adenyl cyclase activity and production of cAMP stimulates the insulin response to the nutrients that are absorbed from the gut [ Baggio 2007, "Biology of incretins: GLP-1 and GIP," Gastroenterology, vol. 132(6):2131-57 ; Hoist 2008, "The incretin system and its role in type 2 diabetes mellitus," Mol Cell Endocrinology, vol.
  • GLP-1R agonism The effects of GLP-1R agonism are multiple. GLP-1 maintains glucose homeostasis by enhancing endogenous glucose dependent insulin secretion, rendering the ⁇ cells glucose competent and sensitive to GLP-1, suppressing glucagon release, restoring first and second phase insulin secretion, slowing gastric emptying, decreasing food intake, and increasing satiety [ Holst 2008 Mol. Cell Endocrinology ; Kjems 2003 "The influence of GLP-1 on glucose-stimulated insulin secretion: effects on beta-cell sensitivity in type 2 and nondiabetic subjects," Diabetes, vol.
  • glucagon refers to a 29 amino acid peptide hormone that is produced by alpha cells in the pancreas and that interacts with GCGR.
  • the amino acid sequence of glucagon is HSQGTFTSDYSKYLDSRRAQDFVQWLMNT-OH (SEQ ID NO: 140).
  • glucagon analog implies structural similarity to glucagon and the term “glucagon receptor agonist” describes a compound that is, functionally, an agonist of the glucagon receptor.
  • glucagon analog and “glucagon receptor agonist” are used alternatively to describe the peptides disclosed herein.
  • Glucagon originates from the 158 amino acid pre-proglucagon peptide which also acts as a precursor for the peptide hormones GLP-1, GLP-2, oxyntomodulin, glicentin, and glicentin-related pancreatic polypeptide via tissue-specific processing.
  • Glucagon corresponds to the amino acid residues 33 to 61 of the precursor peptide and acts via interaction with a class B seven transmembrane G protein-coupled receptor located primarily in the liver. Immunostaining has also indicated the presence of glucagon receptors in the kidneys, gastrointestinal tract, heart, spleen, brain, adipocytes, and lymphoblasts.
  • glucagon In response to low blood glucose levels, glucagon is released and stimulates hepatic glucose output via glycogenolysis and gluconeogenesis. Glucagon acts as a counter to the glucose-lowering effect of insulin and tight regulation via a feed-back system between the two hormones allows for effective glucose homeostasis.
  • glucagon In addition to its effect on blood glucose levels, glucagon is also known to increase energy expenditure and thermogenesis. Increased signaling has a direct effect on the regulation of triglycerides, free fatty acids, apolipoprotein, and bile acid metabolism. Current therapeutic uses for glucagon have primarily focused on its use as a rescue agent for hypoglycemic episodes. However, recent work has taken advantage of the hormone's ability to affect energy balance and lipid metabolism resulting in potential treatments for various metabolic disorders.
  • Vehicle refers to a medium used to carry a compound, e.g ., a drug or a particle containing a drug.
  • Vehicles of the present disclosure typically comprise components such as polymers and solvents.
  • the suspension vehicles of the present disclosure typically comprise solvents and polymers that are used to prepare suspension formulations further comprising drug particle formulations.
  • phase separation refers to the formation of multiple phases (e.g ., liquid and gel phases) in the suspension vehicle, such as when the suspension vehicle contacts the aqueous environment.
  • the suspension vehicle is formulated to exhibit phase separation upon contact with an aqueous environment having less than approximately 10% water.
  • single-phase refers to a solid, semisolid, or liquid homogeneous system that is physically and chemically uniform throughout.
  • dissolving refers to dissolving, dispersing, suspending, or otherwise distributing a compound, for example, a drug particle formulation, in a suspension vehicle.
  • chemically stable refers to formation in a formulation of an acceptable percentage of degradation products produced over a defined period of time by chemical pathways, such as deamidation (usually by hydrolysis), aggregation, or oxidation.
  • a physically stable formulation refers to formation in a formulation of an acceptable percentage of aggregates (e.g ., dimers and other higher molecular weight products). Further, a physically stable formulation does not change its physical state as, for example, from liquid to solid, or from amorphous to crystal form.
  • the ratio of shear stress to shear rate defines viscosity.
  • Measurements of shear stress and shear rate are typically determined using parallel plate rheometry performed under selected conditions (for example, a temperature of about 37° C.).
  • Other methods for the determination of viscosity include, measurement of a kinematic viscosity using viscometers, for example, a Cannon-Fenske viscometer, a Ubbelohde viscometer for the Cannon-Fenske opaque solution, or a Ostwald viscometer.
  • suspension vehicles of the present disclosure have a viscosity sufficient to prevent a particle formulation suspended therein from settling during storage and use in a method of delivery, for example, in an implantable, drug delivery device.
  • non-aqueous refers to an overall moisture content, for example, of a suspension formulation, typically of less than or equal to about 10 wt %, for example, less than or equal to about 7 wt %, less than or equal to about 5 wt %, and/or less than about 4 wt %. Also, a particle formulation of the present disclosure comprises less than about 10 wt %, for example, less than about 5 wt %, residual moisture.
  • subject refers to any member of the subphylum Chordata, including, without limitation, humans and other primates, including non-human primates such as rhesus macaques and other monkey species and chimpanzees and other ape species; farm animals such as cattle, sheep, pigs, goats and horses; domestic mammals such as dogs and cats; laboratory animals including rodents such as mice, rats and guinea pigs; birds, including domestic, wild and game birds such as chickens, turkeys and other gallinaceous birds, ducks, geese, and the like.
  • the term does not denote a particular age or gender. Thus, both adult and newborn individuals are intended to be covered.
  • osmotic delivery device typically refers to a device used for delivery of a drug (e.g., an isolated glucagon-specific agonist polypeptide) to a subject, wherein the device comprises, for example, a reservoir (made, e.g ., from a titanium alloy) having a lumen that contains a suspension formulation comprising a drug (e.g., an isolated glucagon-specific agonist polypeptide) and an osmotic agent formulation.
  • a piston assembly positioned in the lumen isolates the suspension formulation from the osmotic agent formulation.
  • a semi-permeable membrane is positioned at a first distal end of the reservoir adjacent the osmotic agent formulation and a diffusion moderator (which defines a delivery orifice through which the suspension formulation exits the device) is positioned at a second distal end of the reservoir adjacent the suspension formulation.
  • the osmotic delivery device is implanted within the subject, for example, subdermally or subcutaneously ( e.g ., in the inside, outside, or back of the upper arm and in the abdominal area).
  • An exemplary osmotic delivery device is the DUROS® (ALZA Corporation, Mountain View, Calif.) delivery device.
  • osmotic delivery device examples include but are not limited to “osmotic drug delivery device”, “osmotic drug delivery system”, “osmotic device”, “osmotic delivery device”, “osmotic delivery system”, “osmotic pump”, “implantable drug delivery device”, “drug delivery system”, “drug delivery device”, “implantable osmotic pump”, “implantable drug delivery system”, and “implantable delivery system”.
  • Other terms for "osmotic delivery device” are known in the art.
  • continuous delivery typically refers to a substantially continuous release of drug from an osmotic delivery device and into tissues near the implantation site, e.g ., subdermal and subcutaneous tissues.
  • an osmotic delivery device releases drug essentially at a predetermined rate based on the principle of osmosis.
  • Extracellular fluid enters the osmotic delivery device through the semi-permeable membrane directly into the osmotic engine that expands to drive the piston at a slow and consistent rate of travel. Movement of the piston forces the drug formulation to be released through the orifice of the diffusion moderator.
  • release of the drug from the osmotic delivery device is at a slow, controlled, consistent rate.
  • substantially steady-state delivery typically refers to delivery of a drug at or near a target concentration over a defined period of time, wherein the amount of the drug being delivered from an osmotic delivery device is substantially zero-order delivery.
  • Substantial zero-order delivery of an active agent e.g., an isolated glucagon-specific analog
  • the rate of drug delivered is constant and is independent of the drug available in the delivery system; for example, for zero-order delivery, if the rate of drug delivered is graphed against time and a line is fitted to the data the line has a slope of approximately zero, as determined by standard methods ( e.g ., linear regression).
  • drug half-life refers how long it takes a drug to be eliminated from blood plasma by one half of its concentration.
  • a drug's half-life is usually measured by monitoring how a drug degrades when it is administered via injection or intravenously.
  • a drug is usually detected using, for example, a radioimmunoassay (RIA), a chromatographic method, an electrochemiluminescent (ECL) assay, an enzyme linked immunosorbent assay (ELISA) or an immunoenzymatic sandwich assay (IEMA).
  • RIA radioimmunoassay
  • ECL electrochemiluminescent
  • ELISA enzyme linked immunosorbent assay
  • IEMA immunoenzymatic sandwich assay
  • ⁇ g and mcg and ug are understood to mean “micrograms”.
  • ⁇ l and uL are understood to mean “microliter”
  • ⁇ M and uM are understood to mean “micromolar”.
  • serum is meant to mean any blood product from which a substance can be detected.
  • serum includes at least whole blood, serum, and plasma.
  • an amount of [a substance] in a subject's serum would cover “an amount of [the substance] in a subject's plasma”.
  • Baseline is defined as the last assessment on or before the day of the initial placement of an osmotic delivery device (containing drug or placebo).
  • the present disclosure relates to isolated polypeptides that are glucagon-receptor selective analogs and peptide derivatives thereof.
  • an isolated polypeptide of the disclosure is a selective glucagon receptor agonist.
  • an isolated polypeptide of the disclosure binds to a glucagon receptor (GCGR).
  • GCGR glucagon receptor
  • an isolated polypeptide of the disclosure comprises a modified amino acid sequence based on the amino acid sequence of human glucagon: HSQGTFTSDYSKYLDSRRAQDFVQWLMNT-OH (SEQ ID NO: 140), where the modified amino acid sequence includes at least one amino acid substitution, at least two amino acid substitutions, at least three amino acid substitutions, at least four amino acid substitutions, at least five amino acid substitutions, at least six amino acid substitutions, at least seven amino acid substitutions, at least eight amino acid substitutions, at least nine amino acid substitutions, at least 10 amino acid substitutions, at least 11 amino acid substitutions, at least 12 amino acid substitutions, at least 13 amino acid substitutions, at least 14 amino acid substitutions, at least 15 amino acid substitutions, at least 16 amino acid substitutions, at least 17 amino acid substitutions, at least 18 amino acid substitutions, at least 19 amino acid substitutions, at least 20 amino acid substitutions, at least 21 amino acid substitutions, at least 22 amino acid substitutions, at least 23 amino acid substitutions, at least
  • an isolated polypeptide of the disclosure comprises a modified amino acid sequence based on the amino acid sequence of human glucagon: HSQGTFTSDYSKYLDSRRAQDFVQWLMNT-OH (SEQ ID NO: 140), where the modified amino acid sequence includes at least one amino acid substitution, at least two amino acid substitutions, at least three amino acid substitutions, at least four amino acid substitutions, at least five amino acid substitutions, at least six amino acid substitutions, at least seven amino acid substitutions, at least eight amino acid substitutions, at least nine amino acid substitutions, at least 10 amino acid substitutions, at least 11 amino acid substitutions, at least 12 amino acid substitutions, at least 13 amino acid substitutions, at least 14 amino acid substitutions, at least 15 amino acid substitutions, or at least 16 amino acid substitutions, wherein the amino acid substitution(s) is selected from the group consisting of:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 1: X 1 X 2 X 3 GTFTSDX 10 X 11 X 12 X 13 LX 15 X 16 X 17 X 18 AQEFX 23 X 24 X 25 LEDE-Z-tail-(OH/NH 2 ) (SEQ ID NO: 1), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 2: X 1 X 2 X 3 GTFTSDX 10 X 11 X 12 X 13 LX 15 X 16 X 17 X 18 AQEFVX 24 WLEDE-Z-tail-(OH/NH 2 ) (SEQ ID NO: 2), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 3: YSX 3 GTFTSDYSKYLDX 16 X 17 X 18 AQEFVX 24 WLEDE-Z-tail-(OH/NH 2 ) (SEQ ID NO: 3), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 41). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 42). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 43).
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 44). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 45). In some embodiments, an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 46).
  • an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 41). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 42). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 43).
  • an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 44). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 45). In some embodiments, an isolated polypeptide of the disclosure consists of the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 46).
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of
  • the isolated polypeptide is selected from the group consisting of Compound A1, Compound A2, Compound A3, Compound A4, Compound A5 and Compound A6. In some embodiments, the isolated polypeptide is Compound A1. In some embodiments, the isolated polypeptide is Compound A2. In some embodiments, the isolated polypeptide is Compound A3. In some embodiments, the isolated polypeptide is Compound A4. In some embodiments, the isolated polypeptide is Compound A5. In some embodiments, the isolated polypeptide is Compound A6.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 137: YSQGTFTSDYSKYLDSX 17 RAQX 21 FVX 24 WLX 27 X 28 T-OH (SEQ ID NO: 137), wherein:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of YSQGTFTSDYSKYLDSK*RAQE*FVK**WLDE**T-OH (SEQ ID NO: 138), referred to herein as Compound A104 and YSQGTFTSDYSKYLDSK*RAQE*FVK**WLQE**T-OH (SEQ ID NO: 139), referred to herein as Compound A105.
  • the polypeptide consists of an amino acid sequence selected from the group consisting of SEQ IDNOs: 138 and 139.
  • the disclosed peptide is optionally substituted with one or more lipophilic substituents each optionally via a bivalent spacer.
  • Conjugation of one or more lipophilic substituents, each optionally via a bivalent spacer, to a disclosed peptide is intended to prolong the action of the peptide by facilitating binding to serum albumin and delayed renal clearance of the conjugated peptide.
  • Applicant has discovered that certain disclosed peptides, having affinity to albumin and prolonged elimination half-lives in humans, are particularly amenable to the disclosed methods of administration via an implantable osmotic drug delivery device.
  • the disclosed peptide has an elimination half-life (t 1/2 ) in humans of at least about 5 hours following subcutaneous administration. In some embodiments, the disclosed peptide has an elimination half-life (t 1/2 ) in humans of at least about 8 hours, 10 hours, 12 hours, 16 hours, 24 hours or longer following subcutaneous administration.
  • a lipophilic substituent comprises a substituent comprising 4 to 40 carbon atoms, 8 to 25 carbon atoms, or 12 to 22 carbon atoms.
  • the lipophilic substituent may be attached to an amino group of the peptide (e.g ., an ⁇ -amino group of a lysine residue) by means of a carboxyl group of the lipophilic substituent, or optionally an amino group of the spacer, which spacer in turn forms an amide bond with an amino group of the amino acid (e.g., lysine) residue to which it is attached.
  • the peptide comprises three, two, or preferably one lipophilic substituent each with or without an optional spacer.
  • the lipophilic substituent comprises a straight-chain or branched alkyl group. In some embodiments, the lipophilic substituent is an acyl group of a straight-chain or branched fatty acid. In some embodiments, the lipophilic substituent is the acyl group of the formula CH 3 (CH 2 ) n CO-, wherein n is an integer from 4 to 38, an integer from 4 to 24, such as CH 3 (CH 2 ) 6 CO-, CH 3 (CH 2 ) 8 CO-, CH 3 (CH 2 ) 10 CO-, CH 3 (CH 2 ) 12 CO-, CH 3 (CH 2 ) 14 CO-, CH 3 (CH 2 ) 16 CO-, CH 3 (CH 2 ) 18 CO-, CH 3 (CH 2 ) 20 CO- or CH 3 (CH 2 ) 22 CO-. In some embodiments, n is 6, 8, 10, 12, 14, 16, 18, 20 or 22. In some embodiments, the lipophilic substituent is an acyl group of the formula CH 3 (CH 2 ) 14
  • the lipophilic substituent is an acyl group of a straight-chain or branched fatty acid, further substituted with one or more carboxylic acid and/or hydroxamic acid groups.
  • the lipophilic substituent is an acyl group of the formula HOOC(CH 2 ) m CO-, wherein m is an integer from 4 to 38, an integer from 4 to 24, such as HOOC(CH 2 ) 14 CO-, HOOC(CH 2 ) 16 CO-, HOOC(CH 2 ) 18 CO-, HOOC(CH 2 ) 20 CO- or HOOC(CH 2 ) 22 CO-.
  • the lipophilic substituent is HOOC(CH 2 ) 16 CO-.
  • m is 6, 8, 10, 12, 14, 16, 18, 20 or 22.
  • the lipophilic substituent is attached to the parent peptide by means of a bivalent "spacer.”
  • the spacer comprises a bivalent group of Formula I: -N(R 1 )(CHR 2 ) p CO-[N(R 3 )((CH 2 ) 2 O(CH 2 ) 2 O) q (CH 2 )CO-] r (Formula I) wherein
  • each R 1 is hydrogen. In some embodiments, each R 3 is hydrogen. In some embodiments, each R 1 and each R 3 are hydrogen.
  • At least one R 2 is CO 2 H. In some embodiments, one R 2 is CO 2 H.
  • p is 1. In some embodiments, p is 2. In some embodiments, p is 3. In some embodiments, p is 4. In some embodiments, p is 5. In some embodiments, p is 6.
  • q is 1. In some embodiments, q is 2. In some embodiments, q is 3.
  • r is 0. In some embodiments, r is 1.
  • the spacer is ⁇ -glutamyl, i.e., -NH(CHCO 2 H)(CH 2 ) 2 CO--. In some embodiments, the spacer is ⁇ -aminobutanoyl, i.e ., -NH(CH 2 ) 3 CO--. In some embodiments, the spacer is ⁇ -asparagyl, i.e., -NH(CHCO 2 H)(CH 2 )CO--. In some embodiments, the spacer is -NH(CH 2 ) 2 CO--. In some embodiments, the spacer is glycyl. In some embodiments, the spacer is ⁇ -alanyl. In some embodiments, provided is the peptide of SEQ ID NO: 151, described below, wherein the lipophilic substituent is linked to the ⁇ -amino group of a lysine via a spacer.
  • the spacer is -NHCH(CO 2 H)(CH 2 ) 2 CO-[N(R 3 )((CH 2 ) 2 O(CH 2 ) 2 O) q (CH 2 )CO-] r . In some embodiments, the spacer is - NH(CH 2 ) 3 CO--[N(R 3 )((CH 2 ) 2 O(CH 2 ) 2 O) q (CH 2 )CO-] r . In some embodiments, the spacer is -NHCH(CO 2 H)(CH 2 ) 2 CO-NH((CH 2 ) 2 O(CH 2 ) 2 O) 2 (CH 2 )CO-.
  • the spacer is -NH(CH 2 ) 3 CO-NH((CH 2 ) 2 O(CH 2 ) 2 O) 2 (CH 2 )CO-. In some embodiments, the spacer is-NHCH(CO 2 H)CH 2 CO--[N(R 3 )((CH 2 ) 2 O(CH 2 ) 2 O) q (CH 2 )CO-] r . In some embodiments, the spacer is -NH(CH 2 ) 2 CO--[N(R 3 )((CH 2 ) 2 O(CH 2 ) 2 O) q (CH 2 )CO-] r .
  • the spacer is an amino acid, for example, Lys, Glu or Asp, or a dipeptide such as Gly-Lys.
  • the spacer when the spacer is Lys, Glu or Asp, one carboxyl group of the spacer may form an amide bond with an amino group of the disclosed peptide, and an amino group of the spacer may form an amide bond with a carboxyl group of the lipophilic substituent.
  • the lipophilic substituent and spacer combine to form the structure of Formula II:
  • the lipophilic substituent and spacer combine to form the structure of Formula III:
  • each lipophilic substituent is attached, optionally via a spacer, to the ⁇ -amino group of a lysine residue contained in the parent peptide.
  • isolated polypeptide wherein the isolated polypeptide is selected from the group consisting of Compounds A1-A105, and the isolated polypeptide is covalently joined to a lipophilic substituent, optionally via a spacer.
  • the isolated polypeptide is selected from the group consisting of Compounds A1-A6, and the isolated polypeptide is covalently joined to a lipophilic substituent, optionally via a spacer.
  • the isolated polypeptide is selected from the group consisting of Compounds A97-A103, and the isolated polypeptide is covalently joined to a lipophilic substituent, optionally via a spacer.
  • the lipophilic substituents is covalently bound to any of the peptides of Compounds A1-A105, such as any of Compounds A1, A2, A3, A4, A5 or A6, via a spacer, and the lipophilic substituent and spacer are of Formula II.
  • the lipophilic substituents is covalently bound to any of the peptides of Compounds A1-A105, such as any of Compounds A1, A2, A3, A4, A5 or A6, via a spacer, and the lipophilic substituent and spacer are of Formula III.
  • the lipophilic substituents is covalently bound to any of the peptides of Compounds A1-A105, such as any of Compounds A97, A98, A99, A100, A101, A102 or A103, via a spacer, and the lipophilic substituent and spacer are of Formula II.
  • the lipophilic substituents is covalently bound to any of the peptides of Compounds A1-A105, such as any of Compounds A97, A98, A99, A100, A101, A102 or A103, via a spacer, and the lipophilic substituent and spacer are of Formula III.
  • isolated polypeptide comprises a lysine, and the ⁇ -amino group of the lysine is covalently bound to the lipophilic substituent, optionally via a spacer.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 151: X 1 SX 3 GTFTSDX 10 SKYLDX 16 X 17 X 18 AQX 21 FVX 24 WLEDEPX 31 SX 33 X 34 PPPS-OH (SEQ ID NO: 151), wherein:
  • K*** is lysine, and the ⁇ -amino group of the lysine sidechain is covalently joined to a lipophilic substituent via a spacer. In some embodiments, K*** is lysine, and the ⁇ -amino group of the lysine sidechain is covalently joined to a lipophilic substituent in the absence of ( i.e ., without) a spacer.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 151 wherein:
  • K*** is lysine, and the ⁇ -amino group of the lysine sidechain is covalently joined to a lipophilic substituent via a spacer. In some embodiments, K*** is lysine, and the ⁇ -amino group of the lysine sidechain is covalently joined to a lipophilic substituent in the absence of ( i.e ., without) a spacer.
  • X16 is K***; in some embodiments, X21 is K***; in some embodiments, X24 is K***; in some embodiments, X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula II:
  • X16 is K***; in some embodiments, X21 is K***; in some embodiments, X24 is K***; in some embodiments, X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula III:
  • one or more of X10, X16, X17, X21, X24, X31 or X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula II.
  • one or more of X10, X16, X17, X21, X24, X31 or X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula III.
  • one of X10, X16, X17, X21, X24, X31 or X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula II.
  • one of X10, X16, X17, X21, X24, X31 or X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula III.
  • provided is a pharmaceutical composition comprising any of the disclosed peptides formulated as a trifluoroacetate salt, acetate salt or hydrochloride salt. In some embodiments, provided is a pharmaceutical composition comprising any of the disclosed peptides formulated as a trifluoroacetate salt. In some embodiments, provided is a pharmaceutical composition comprising any of the disclosed peptides formulated as an acetate salt. In some embodiments, provided is a pharmaceutical composition comprising any of the disclosed peptides formulated as a hydrochloride salt.
  • a pharmaceutical composition comprising any of the disclosed peptides formulated as a trifluoroacetate salt, acetate salt or hydrochloride salt, and the peptide comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 151.
  • a pharmaceutical composition comprising any of the disclosed peptides formulated as a trifluoroacetate salt and the peptide comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 151.
  • a pharmaceutical composition comprising any of the disclosed peptides formulated as an acetate salt and the peptide comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 151.
  • a pharmaceutical composition comprising any of the disclosed peptides formulated as a hydrochloride salt and the peptide comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by the consensus sequence of SEQ ID NO: 151.
  • one of X10, X16, X17, X21, X24, X31 or X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula II.
  • one of X10, X16, X17, X21, X24, X31 or X33 is K***, where K*** is lysine, and the ⁇ -amino group of the lysine is covalently joined to a lipophilic substituent and a spacer of Formula III.
  • polypeptides of the disclosure wherein the polypeptide comprises one or more amino acid residues, each of which is covalently joined to a lipophilic substituent, optionally via a spacer, both as defined herein.
  • each of the one or more amino acid residues is covalently joined to a lipophilic substituent and a spacer of Formula II or III.
  • any of the isolated polypeptides of the disclosure wherein the polypeptide comprises at least one lysine residue, where the ⁇ -amino group of the lysine sidechain is covalently joined to a lipophilic substituent, optionally via a spacer, both as defined herein.
  • each of the at least one lysine residues has an ⁇ -amino group that is covalently joined to a lipophilic substituent and a spacer of Formula II or III.
  • the isolated polypeptide is selected from the group consisting of Compounds B1-B48.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFV(Aib)WLEDEPSSK****APPPS-OH (SEQ ID NO: 152) which is also referred to herein as Compound B1.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFVK****WLEDEPSSGAPPPS-OH (SEQ ID NO: 153) which is also referred to herein as Compound B2.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK****KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 154) which is also referred to herein as Compound B3.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK****SKYLD(Aib)KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 155) which is also referred to herein as Compound B4.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFV(Aib)WLEDEPSSK***** APPPS-OH (SEQ ID NO: 156) which is also referred to herein as Compound B5.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KYAQEFVK*****WLEDEPSSGAPPPS-OH (SEQ ID NO: 157) which is also referred to herein as Compound B6.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK*****KYAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 158) which is also referred to herein as Compound B7.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK*****SKYLD(Aib)KYAQEFV(Aib)WLEDEPSSGAPPPS -OH (SEQ ID NO: 159) which is also referred to herein as Compound B8.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFV(Aib)WLEDEPSSK****APPPS-OH (SEQ ID NO: 160) which is also referred to herein as Compound B9.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFVK****WLEDEPSSGAPPPS-OH (SEQ ID NO: 161) which is also referred to herein as Compound B10.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK****KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 162) which is also referred to herein as Compound B11.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK****SKYLD(Aib)KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 163) which is also referred to herein as Compound B12.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFV(Aib)WLEDEPSSK***** APPPS-OH (SEQ ID NO: 164) which is also referred to herein as Compound B13.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KSAQEFVK*****WLEDEPSSGAPPPS-OH (SEQ ID NO: 165) which is also referred to herein as Compound B14.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK*****KSAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 166) which is also referred to herein as Compound B15.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK*****SKYLD(Aib)KSAQEFV(Aib)WLEDEPSSGAPPP S-OH (SEQ ID NO: 167) which is also referred to herein as Compound B16.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSK****APPPS-OH (SEQ ID NO: 168) which is also referred to herein as Compound B17.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFVK****WLEDEPSSGAPPPS-OH (SEQ ID NO: 169) which is also referred to herein as Compound B18.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLDK****KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 170) which is also referred to herein as Compound B19.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDK****SKYLD(Aib)KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 171) which is also referred to herein as Compound B20.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFV(Aib)WLEDEPSSK***** APPPS-OH (SEQ ID NO: 172) which is also referred to herein as Compound B21.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLD(Aib)KRAQEFVK*****WLEDEPSSGAPPPS-OH (SEQ ID NO: 173) which is also referred to herein as Compound B22.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDYSKYLDK*****KRAQEFV(Aib)WLEDEPSSGAPPPS-OH (SEQ ID NO: 174) which is also referred to herein as Compound B23.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence WSQGTFTSDK*****SKYLD(Aib)KRAQEFV(Aib)WLEDEPSS GAPPPS-OH (SEQ ID NO: 175) which is also referred to herein as Compound B24.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFVIWLEDEPSSK****APPPS-OH (SEQ ID NO: 176) which is also referred to herein as Compound B25.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK****KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 177) which is also referred to herein as Compound B26.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK****SKYLD(Aib)KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 178) which is also referred to herein as Compound B27.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQK****FVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 179) which is also referred to herein as Compound B28.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQEFVIWLEDEPSSK*****APPPS-OH (SEQ ID NO: 180) which is also referred to herein as Compound B29.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLD(Aib)KRAQK*****FVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 181) which is also referred to herein as Compound B30.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK*****KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 182) which is also referred to herein as Compound B31.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK*****SKYLD(Aib)KRAQEFVIWLEDEPSSGAPPPS-OH (SEQ ID NO: 183) which is also referred to herein as Compound B32.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVKWLEDEPKSK****SPPPS-NH 2 (SEQ ID NO: 184) which is also referred to herein as Compound B33.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVK****WLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 185) which is also referred to herein as Compound B34.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDK****ARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 186) which is also referred to herein as Compound B35.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDK****SKYLDAARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 187) which is also referred to herein as Compound B36.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVKWLEDEPKSK*****SPPPS-NH 2 (SEQ ID NO: 188) which is also referred to herein as Compound B37.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDAARAQEFVK*****WLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 189) which is also referred to herein as Compound B38.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDYSKYLDK*****ARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 190) which is also referred to herein as Compound B39.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSQGTFTSDK*****SKYLDAARAQEFVKWLEDEPKSKSPPPS-NH 2 (SEQ ID NO: 191) which is also referred to herein as Compound B40.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVKWLEDEPSSK****APPPS-NH 2 (SEQ ID NO: 192) which is also referred to herein as Compound B41.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVK****WLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 193) which is also referred to herein as Compound B42.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK****ARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 194) which is also referred to herein as Compound B43.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK****SKYLDSARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 195) which is also referred to herein as Compound B44.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVKWLEDEPSSK*****APPPS-NH 2 (SEQ ID NO: 196) which is also referred to herein as Compound B45.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDSARAQEFVK*****WLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 197) which is also referred to herein as Compound B46.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDYSKYLDK*****ARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 198) which is also referred to herein as Compound B47.
  • an isolated polypeptide of the disclosure comprises the amino acid sequence YSHGTFTSDK*****SKYLDSARAQEFVKWLEDEPSSGAPPPS-NH 2 (SEQ ID NO: 199) which is also referred to herein as Compound B48.
  • each ⁇ -amino group of the lysine residue located at the indicated peptide residue (K****) in the disclosed compounds is covalently bound to the indicated carbonyl of Formula II to form an amide:
  • each ⁇ -amino group of the lysine residue located at the indicated peptide residue (K*****) in the disclosed compounds is covalently bound to the indicated carbonyl of Formula III to form an amide:
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by SEQ ID NO: 152 through SEQ ID NO: 199.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B1 through Compound B8.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B9 through Compound B16.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B17 through Compound B24.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B25 through Compound B32.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B33 through Compound B40.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B41 through Compound B48.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by SEQ ID NO: 154, SEQ ID NO: 157, SEQ ID NO: 158, SEQ ID NO: 160, SEQ ID NO: 161, SEQ ID NO: 162, SEQ ID NO: 165, SEQ ID NO: 166, SEQ ID NO: 168, SEQ ID NO: 172, SEQ ID NO: 173, SEQ ID NO: 185, SEQ ID NO: 188, SEQ ID NO: 189, SEQ ID NO: 190 and SEQ ID NO: 192.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by SEQ ID NO: 160, SEQ ID NO: 165, and SEQ ID NO: 166.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B1 through Compound B48.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B3, Compound B6, Compound B7, Compound B9, Compound B10, Compound B11, Compound B14, Compound B15, Compound B17, Compound B21, Compound B22, Compound B34, Compound B37, Compound B38, Compound B39 and Compound B41.
  • an isolated polypeptide of the disclosure is selected from the group consisting of Compound B9, Compound B14 and Compound B15.
  • an isolated polypeptide of the disclosure is Compound B9. In some embodiments, an isolated polypeptide of the disclosure is Compound B14. In some embodiments, an isolated polypeptide of the disclosure is Compound B15.
  • an isolated polypeptide of the disclosure comprises an amino acid sequence selected from the group consisting of amino acid sequences represented by Compound B1 through Compound B48.
  • an isolated glucagon analog polypeptide of the disclosure which is a selective glucagon receptor agonist, is co-formulated in combination with a second agent selected from the group consisting of oxyntomodulin, exenatide, a derivative of exenatide, an analogue of exenatide, glucagon-like peptide-1 (GLP-1), a derivative of GLP-1, and an analogue of GLP-1.
  • a second agent selected from the group consisting of oxyntomodulin, exenatide, a derivative of exenatide, an analogue of exenatide, glucagon-like peptide-1 (GLP-1), a derivative of GLP-1, and an analogue of GLP-1.
  • GLP-1 glucagon-like peptide-1
  • any of the glucagon analogs of the disclosure is co-formulated in combination with exenatide.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is not covalently joined to a lipophilic substituent and a spacer, as described herein.
  • a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is selected from the group consisting of Compounds A1-A105. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is selected from the group consisting of Compounds A1, A2, A3, A4, A5 and A6. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound A1. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound A2.
  • a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound A3. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound A4. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound A5. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound A6.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide, wherein the glucagon analog has at least one amino acid that is covalently joined to a lipophilic substituent and a spacer, as described herein. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide, wherein the glucagon analog has at least one lysine residue that has an ⁇ -amino group that is covalently joined to a lipophilic substituent and a spacer of Formula II or III.
  • a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is selected from the group consisting of Compounds B1-B48.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is selected from the group consisting of amino acid sequences represented by SEQ ID NO: 152-SEQ ID NO: 199.
  • a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is selected from the group consisting of Compound B3, Compound B6, Compound B7, Compound B9, Compound B10, Compound B11, Compound B14, Compound B15, Compound B17, Compound B21, Compound B22, Compound B34, Compound B37, Compound B38, Compound B39 and Compound B41.
  • a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is selected from the group consisting of Compound B9, Compound B14 and Compound B15.
  • a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound B9. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound B14. In some embodiments, a glucagon analog of the disclosure is formulated in combination with exenatide, wherein the glucagon analog is Compound B15.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 1000:1 to 1:1000. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 500:1 to 1:500. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 100:1 to 1:100.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 50:1 to 1:50. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 25:1 to 1:25. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 10:1 to 1:10.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 1:1 to 1:10. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 10:1 to 1:1. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 5:1 to 1:5.
  • any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 1:1 to 1:5. In some embodiments, any of the glucagon analogs of the disclosure is formulated in combination with exenatide in a fixed ratio of glucagon analog:exenatide of 5:1 to 1:1.
  • the disclosure also provides a method of treating type 2 diabetes mellitus in a subject in need of treatment.
  • the method comprises providing one or more of the isolated glucagon-receptor selective agonist polypeptides of the disclosure.
  • the method comprises providing continuous delivery of an isolated glucagon-receptor selective agonist polypeptide from an osmotic delivery device, wherein substantial steady-state delivery of the isolated glucagon-specific agonist polypeptide at a therapeutic concentration is achieved within a time period of about 7 days or less after implantation of the osmotic delivery device in the subject.
  • the substantial steady-state delivery of the isolated glucagon-specific agonist polypeptide from the osmotic delivery device is continuous over an administration period. Humans are preferred subjects for the practice of the present disclosure.
  • the administration period is, for example, at least about 3 months, at least about 3 months to about a year, at least about 4 months to about a year, at least about 5 months to about a year, at least about 6 months to about a year, at least about 8 months to about a year, at least about 9 months to about a year, at least about 10 months to about a year, at least about one year to about two years, at least about two years to about three years.
  • the substantial steady-state delivery of an isolated glucagon-specific agonist polypeptide at therapeutic concentrations is achieved within about 5 days or less after implantation of the osmotic delivery device in the subject, within about 4 days or less after implantation of the osmotic delivery device in the subject, within about 3 days or less after implantation of the osmotic delivery device in the subject, within about 2 days or less after implantation of the osmotic delivery device in the subject, or within about 1 day or less after implantation of the osmotic delivery device in the subject.
  • the substantial steady-state delivery of the isolated glucagon-specific agonist polypeptide at therapeutic concentrations is achieved within about 2 days or less, more preferably within about 1 day or less after implantation of the osmotic delivery device in the subject.
  • the treatment methods provide significant decrease in the subject's fasting plasma glucose concentration after implantation of the osmotic delivery device in the subject (relative to the subject's fasting plasma glucose concentration before implantation of the osmotic delivery device) that is achieved within about 7 days or less after implantation of the osmotic delivery device in the subject, within about 6 days or less after implantation of the osmotic delivery device in the subject, within about 5 days or less after implantation of the osmotic delivery device in the subject, within about 4 days or less after implantation of the osmotic delivery device in the subject, within about 3 days or less after implantation of the osmotic delivery device in the subject, within about 2 days or less after implantation of the osmotic delivery device in the subject, or within about 1 day or less after implantation of the osmotic delivery device in the subject.
  • the significant decrease in the subject's fasting plasma glucose concentration after implantation of the osmotic delivery device, relative to the subject's fasting plasma glucose concentration before implantation is achieved within about 2 days or less, preferably within about 1 day or less after implantation of the osmotic delivery device in the subject, or more preferably within about 1 day after implantation of the osmotic delivery device in the subject.
  • the significant decrease in fasting plasma glucose is typically statistically significant as demonstrated by application of an appropriate statistical test or is considered significant for the subject by a medical practitioner.
  • a significant decrease in fasting plasma glucose relative to the baseline before implantation is typically maintained over the administration period.
  • the treatment methods further comprise the capability to terminate the continuous delivery of the glucagon-specific agonist polypeptide such that the concentration of the glucagon-specific agonist polypeptide is substantially undetectable in a blood sample from the subject within about 6 half-lives or less of the glucagon-specific agonist polypeptide after termination of continuous delivery, within about 5 half-lives or less of the glucagon-specific agonist polypeptide after termination of continuous delivery, within about 4 half-lives or less of the glucagon-specific agonist polypeptide after termination of continuous delivery, or within about 3 half-lives or less of the glucagon-specific agonist polypeptide after termination of continuous delivery.
  • the glucagon-specific agonist polypeptide may be detected, for example, by an RIA, a chromatographic method, an ECL assay, an ELISA, or an IEMA. Termination of the continuous delivery can be accomplished, for example, by removal of the osmotic delivery device from the subject.
  • the treatment methods further comprise the capability to terminate the continuous delivery of the glucagon-receptor selective agonist polypeptide such that the concentration of the polypeptide is substantially undetectable in a blood sample from the subject in less than about 72 hours after termination of continuous delivery, in less than about 48 hours after termination of continuous delivery, in less than about 24 hours after termination of continuous delivery, in less than about 18 hours after termination of continuous delivery, in less than about 14 hours after termination of continuous delivery, in less than about 12 hours after termination of continuous delivery, in less than about 6 hours after termination of continuous delivery, or in less than about 4 hours after termination of continuous delivery.
  • the glucagon-specific agonist polypeptide is substantially undetectable in a blood sample from the subject in less than about 24 hours after termination of continuous delivery, in less than about 18 hours after termination of continuous delivery, or more preferably in less than about 14 hours after termination of continuous delivery.
  • the glucagon-receptor selective agonist polypeptide is formulated in a suspension formulation.
  • the suspension formulation comprises a particle formulation comprising the glucagon-receptor selective agonist polypeptide, and a vehicle formulation.
  • the glucagon-receptor selective agonist polypeptide comprises an isolated polypeptide of the disclosure, a peptide analog thereof, or a peptide derivative thereof.
  • the glucagon-receptor selective agonist polypeptide comprises an amino acid sequence encompassed by the amino acid sequence of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 3, or SEQ ID NO: 137.
  • the glucagon-receptor selective agonist polypeptide comprises an amino acid sequence selected from the group consisting of SEQ ID NOs: 4-139.
  • suspension formulations for use in the methods can, for example, comprise a particle formulation comprising an isolated glucagon-receptor selective agonist polypeptide, and a vehicle formulation.
  • the reservoir of the osmotic delivery devices may, for example, comprise titanium or a titanium alloy.
  • the present disclosure relates to a method of treating a disease or condition in a subject in need of treatment.
  • the method comprises providing continuous delivery of a drug from an osmotic delivery device, wherein substantial steady-state delivery of the drug at therapeutic concentrations is achieved within a time period of about 7 days or less after implantation of the osmotic delivery device in the subject.
  • the substantial steady-state delivery of the drug from the osmotic delivery device is continuous over an administration period of at least about 3 months.
  • the drug has a known or determined half-life in a typical subject. Humans are preferred subjects for the practice of the present disclosure.
  • the present disclosure includes a drug effective for treatment of the disease or condition, as well as an osmotic delivery device comprising the drug for use in the present methods of treating the disease or condition in a subject in need of treatment.
  • Advantages of the present disclosure include mitigation of peak-associated drug toxicities and attenuation of sub-optimal drug therapy associated with troughs.
  • the administration period is, for example, at least about 3 months, at least about 3 months to about a year, at least about 4 months to about a year, at least about 5 months to about a year, at least about 6 months to about a year, at least about 8 months to about a year, at least about 9 months to about a year, or at least about 10 months to about a year.
  • the substantial steady-state delivery of a drug at therapeutic concentrations is achieved within a period of about 7 days or less after implantation of the osmotic delivery device in the subject, about 5 days or less after implantation of the osmotic delivery device in the subject, about 4 days or less after implantation of the osmotic delivery device in the subject, about 3 days or less after implantation of the osmotic delivery device in the subject, about 2 days or less after implantation of the osmotic delivery device in the subject, or about 1 day or less after implantation of the osmotic delivery device in the subject.
  • establishment of the substantial steady-state delivery of the drug at therapeutic concentrations, after implantation of the osmotic delivery device in the subject may take a longer period of time, for example, a period of about 2 weeks or less, or within less than about 6 half-lives of the drug within the subject after implantation of the device.
  • the disclosure also provides a method for promoting weight loss in a subject in need thereof, a method for treating excess weight or obesity in a subject in need thereof, and/or a method for suppressing appetite in a subject in need thereof.
  • the method comprises providing delivery of an isolated glucagon-receptor selective agonist polypeptide.
  • the isolated glucagon-receptor selective agonist polypeptide is continuously delivered from an osmotic delivery device, wherein substantial steady-state delivery of the glucagon-receptor selective agonist polypeptide at a therapeutic concentration is achieved within a time period of about 7 days or less after implantation of the osmotic delivery device in the subject.
  • the substantial steady-state delivery of the glucagon-receptor selective agonist polypeptide from the osmotic delivery device is continuous over an administration period.
  • Humans are preferred subjects for the practice of the present disclosure.
  • the present disclosure includes an isolated glucagon-receptor selective agonist polypeptide, as well as an osmotic delivery device comprising an isolated glucagon-receptor selective agonist polypeptide for use in the present methods in a subject in need of treatment.
  • They subject may have type 2 diabetes.
  • the subject in need thereof may have a baseline HbAlc % of greater than 10.0%, i.e., a high baseline (HBL) subject.
  • HBL high baseline
  • the subject may not have previously received a drug for treating type 2 diabetes mellitus.
  • the administration period is, for example, at least about 3 months, at least about 3 months to about a year, at least about 4 months to about a year, at least about 5 months to about a year, at least about 6 months to about a year, at least about 8 months to about a year, at least about 9 months to about a year, or at least about 10 months to about a year, at least about one year to about two years, or at least about two years to about three years.
  • the treatment methods of the present disclosure provide significant decrease in the subject's fasting plasma glucose concentration after implantation of the osmotic delivery device in the subject (relative to the subject's fasting plasma glucose concentration before implantation of the osmotic delivery device) that is achieved within about 7 days or less after implantation of the osmotic delivery device in the subject, within about 6 days or less after implantation of the osmotic delivery device in the subject, within about 5 days or less after implantation of the osmotic delivery device in the subject, within about 4 days or less after implantation of the osmotic delivery device in the subject, within about 3 days or less after implantation of the osmotic delivery device in the subject, within about 2 days or less after implantation of the osmotic delivery device in the subject, or within about 1 day or less after implantation of the osmotic delivery device in the subject.
  • the significant decrease in the subject's fasting plasma glucose concentration after implantation of the osmotic delivery device, relative to the subject's fasting plasma glucose concentration before implantation is achieved within about 2 days or less, preferably within about 1 day or less after implantation of the osmotic delivery device in the subject, or more preferably within about 1 day after implantation of the osmotic delivery device in the subject.
  • the significant decrease in fasting plasma glucose is typically statistically significant as demonstrated by application of an appropriate statistical test or is considered significant for the subject by a medical practitioner.
  • a significant decrease in fasting plasma glucose relative to the baseline before implantation is typically maintained over the administration period.
  • an exemplary osmotic delivery device comprises the following: an impermeable reservoir comprising interior and exterior surfaces and first and second open ends; a semi-permeable membrane in sealing relationship with the first open end of the reservoir; an osmotic engine within the reservoir and adjacent the semi-permeable membrane; a piston adjacent the osmotic engine, wherein the piston forms a movable seal with the interior surface of the reservoir, the piston divides the reservoir into a first chamber and a second chamber, the first chamber comprising the osmotic engine; a drug formulation or suspension formulation comprising the drug, wherein the second chamber comprises the drug formulation or suspension formulation and the drug formulation or suspension formulation is flowable; and a diffusion moderator inserted in the second open end of the reservoir, the diffusion moderator adjacent the suspension formulation.
  • the reservoir comprises titanium or a titanium alloy.
  • the drug formulation can comprise the drug and a vehicle formulation.
  • suspension formulations are used in the methods and can, for example, comprise a particle formulation comprising the drug and a vehicle formulation.
  • Vehicle formulations for use in forming the suspension formulations of the present disclosure can, for example, comprise a solvent and a polymer.
  • the reservoir of the osmotic delivery devices may, for example, comprise titanium or a titanium alloy.
  • the implanted osmotic delivery device can be used to provide subcutaneous delivery.
  • the continuous delivery can, for example, be zero-order, controlled continuous delivery.
  • Drugs for use in the practice of the present disclosure are typically uniformly suspended, dissolved or dispersed in a suspension vehicle to form a suspension formulation.
  • compositions suitable for administration can be incorporated into pharmaceutical compositions suitable for administration.
  • Such compositions typically comprise the fusion protein and a pharmaceutically acceptable carrier.
  • pharmaceutically acceptable carrier is intended to include any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like, compatible with pharmaceutical administration. Suitable carriers are described in the most recent edition of Remington's Pharmaceutical Sciences, a standard reference text in the field.
  • Such carriers or diluents include, but are not limited to, water, saline, ringer's solutions, dextrose solution, and 5% human serum albumin. Liposomes and non-aqueous vehicles such as fixed oils may also be used.
  • the use of such media and agents for pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the active compound, use thereof in the compositions is contemplated. Supplementary active compounds can also be incorporated into the compositions.
  • a pharmaceutical composition of the disclosure is formulated to be compatible with its intended route of administration.
  • routes of administration include parenteral, e.g., intravenous, intradermal, subdermal, subcutaneous, oral ( e.g., inhalation), transdermal ( i.e., topical), transmucosal, rectal, or combinations thereof.
  • a pharmaceutical composition or an isolated polypeptide of the disclosure is formulated for administration by topical administration.
  • a pharmaceutical composition or an isolated polypeptide of the disclosure is formulated for administration by inhalation administration.
  • the pharmaceutical composition is formulated for administration by a device or other suitable delivery mechanism that is suitable for subdermal or subcutaneous implantation and delivers the pharmaceutical composition subcutaneously.
  • the pharmaceutical composition is formulated for administration by an implant device that is suitable for subdermal or subcutaneous implantation and delivers the pharmaceutical composition subcutaneously.
  • the pharmaceutical composition is formulated for administration by an osmotic delivery device, e.g., an implantable osmotic delivery device, that is suitable for subdermal or subcutaneous placement or other implantation and delivers the pharmaceutical composition subcutaneously.
  • Solutions or suspensions used for parenteral application, intradermal application, subdermal application, subcutaneous application, or combinations thereof can include the following components: a sterile diluent such as water for injection, saline solution, fixed oils, polyethylene glycols, glycerine, propylene glycol or other synthetic solvents; antibacterial agents such as benzyl alcohol or methyl parabens; antioxidants such as ascorbic acid or sodium bisulfite; chelating agents such as ethylenediaminetetraacetic acid (EDTA); buffers such as acetates, citrates or phosphates, and agents for the adjustment of tonicity such as sodium chloride or dextrose.
  • the pH can be adjusted with acids or bases, such as hydrochloric acid or sodium hydroxide.
  • the parenteral preparation can be enclosed in ampoules, disposable syringes or multiple dose vials made of glass or plastic.
  • compositions suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersion.
  • suitable carriers include physiological saline, bacteriostatic water, Cremophor ELTM (BASF, Parsippany, N.J.) or phosphate buffered saline (PBS).
  • the composition must be sterile and should be fluid to the extent that easy syringeability exists. It must be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms such as bacteria and fungi.
  • the carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), and suitable mixtures thereof.
  • the proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants.
  • Prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like.
  • isotonic agents for example, sugars, polyalcohols such as manitol, sorbitol, sodium chloride in the composition.
  • Prolonged absorption of the injectable compositions can be brought about by including in the composition an agent which delays absorption, for example, aluminum monostearate and gelatin.
  • Sterile injectable solutions can be prepared by incorporating the active compound in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization.
  • dispersions are prepared by incorporating the active compound into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above.
  • methods of preparation are vacuum drying and freeze-drying that yields a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof.
  • Oral compositions generally include an inert diluent or an edible carrier. They can be enclosed in gelatin capsules or compressed into tablets. For the purpose of oral therapeutic administration, the active compound can be incorporated with excipients and used in the form of tablets, troches, or capsules. Oral compositions can also be prepared using a fluid carrier for use as a mouthwash, wherein the compound in the fluid carrier is applied orally and swished and expectorated or swallowed. Pharmaceutically compatible binding agents, and/or adjuvant materials can be included as part of the composition.
  • the tablets, pills, capsules, troches and the like can contain any of the following ingredients, or compounds of a similar nature: a binder such as microcrystalline cellulose, gum tragacanth or gelatin; an excipient such as starch or lactose, a disintegrating agent such as alginic acid, Primogel, or corn starch; a lubricant such as magnesium stearate or Sterotes; a glidant such as colloidal silicon dioxide; a sweetening agent such as sucrose or saccharin; or a flavoring agent such as peppermint, methyl salicylate, or orange flavoring.
  • a binder such as microcrystalline cellulose, gum tragacanth or gelatin
  • an excipient such as starch or lactose, a disintegrating agent such as alginic acid, Primogel, or corn starch
  • a lubricant such as magnesium stearate or Sterotes
  • a glidant such as colloidal silicon dioxide
  • the compounds are delivered in the form of an aerosol spray from pressured container or dispenser which contains a suitable propellant, e.g., a gas such as carbon dioxide, or a nebulizer.
  • a suitable propellant e.g., a gas such as carbon dioxide, or a nebulizer.
  • Systemic administration can also be by transmucosal or transdermal means.
  • penetrants appropriate to the barrier to be permeated are used in the formulation.
  • penetrants are generally known in the art, and include, for example, for transmucosal administration, detergents, bile salts, and fusidic acid derivatives.
  • Transmucosal administration can be accomplished through the use of nasal sprays or suppositories.
  • the active compounds are formulated into ointments, salves, gels, or creams as generally known in the art.
  • the compounds can also be prepared in the form of suppositories (e.g ., with conventional suppository bases such as cocoa butter and other glycerides) or retention enemas for rectal delivery.
  • suppositories e.g ., with conventional suppository bases such as cocoa butter and other glycerides
  • retention enemas for rectal delivery.
  • the active compounds are prepared with carriers that will protect the compound against rapid elimination from the body, such as a controlled release formulation, including implants and microencapsulated delivery systems.
  • a controlled release formulation including implants and microencapsulated delivery systems.
  • Biodegradable, biocompatible polymers can be used, such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen, polyorthoesters, and polylactic acid. Methods for preparation of such formulations will be apparent to those skilled in the art.
  • the materials can also be obtained commercially from Alza Corporation and Nova Pharmaceuticals, Inc.
  • Liposomal suspensions can also be used as pharmaceutically acceptable carriers. These can be prepared according to methods known to those skilled in the art, for example, as described in U.S. Patent No. 4,522,811 .
  • Dosage unit form refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier.
  • the specification for the dosage unit forms of the disclosure are dictated by and directly dependent on the unique characteristics of the active compound and the particular therapeutic effect to be achieved, and the limitations inherent in the art of compounding such an active compound for the treatment of individuals.
  • compositions can be included in a container, pack, or dispenser together with instructions for administration.
  • the present disclosure provides drug particle formulations for pharmaceutical use.
  • the particle formulation typically comprises a drug and includes one or more stabilizing component (also referred to herein as "excipients").
  • stabilizing components include, but are not limited to, carbohydrates, antioxidants, amino acids, buffers, inorganic compounds, and surfactants.
  • the particle formulation may comprise about 50 wt % to about 90 wt % drug, about 50 wt % to about 85 wt % drug, about 55 wt % to about 90 wt % drug, about 60 wt % to about 90 wt % drug, about 65 wt % to about 85 wt % drug, about 65 wt % to about 90 wt % drug, about 70 wt % to about 90 wt % drug, about 70 wt % to about 85 wt % drug, about 70 wt % to about 80 wt % drug, or about 70 wt % to about 75 wt % drug.
  • a particle formulation comprises a drug, as described above, and one or more stabilizer.
  • the stabilizers may be, for example, carbohydrate, antioxidant, amino acid, buffer, inorganic compound, or surfactant.
  • the amounts of stabilizers in the particle formulation can be determined experimentally based on the activities of the stabilizers and the desired characteristics of the formulation, in view of the teachings of the present specification.
  • the amount of carbohydrate in the formulation is determined by aggregation concerns. In general, the carbohydrate amount should not be too high so as to avoid promoting crystal growth in the presence of water due to excess carbohydrate unbound to drug.
  • the amount of antioxidant in the formulation is determined by oxidation concerns, while the amount of amino acid in the formulation is determined by oxidation concerns and/or formability of particles during spray drying.
  • the amount of buffer in the formulation is determined by pre-processing concerns, stability concerns, and formability of particles during spray drying.
  • Buffer may be required to stabilize drug during processing, e . g ., solution preparation and spray drying, when all stabilizers are solubilized.
  • carbohydrates examples include, but are not limited to, monosaccharides (e . g ., fructose, maltose, galactose, glucose, D-mannose, and sorbose), disaccharides ( e . g ., lactose, sucrose, trehalose, and cellobiose), polysaccharides ( e . g ., raffinose, melezitose, maltodextrins, dextrans, and starches), and alditols (acyclic polyols; e .
  • monosaccharides e . g ., fructose, maltose, galactose, glucose, D-mannose, and sorbose
  • disaccharides e . g ., lactose, sucrose, trehalose, and cellobiose
  • polysaccharides e . g ., raffinose,
  • Suitable carbohydrates include disaccharides and/or non-reducing sugars, such as sucrose, trehalose, and raffinose.
  • antioxidants examples include, but are not limited to, methionine, ascorbic acid, sodium thiosulfate, catalase, platinum, ethylenediaminetetraacetic acid (EDTA), citric acid, cysteine, thioglycerol, thioglycolic acid, thiosorbitol, butylated hydroxanisol, butylated hydroxyltoluene, and propyl gallate.
  • amino acids that readily oxidize can be used as antioxidants, for example, cysteine, methionine, and tryptophan.
  • amino acids examples include, but are not limited to, arginine, methionine, glycine, histidine, alanine, L-leucine, glutamic acid, iso-leucine, L-threonine, 2-phenylamine, valine, norvaline, proline, phenylalanine, tryptophan, serine, asparagines, cysteine, tyrosine, lysine, and norleucine.
  • Suitable amino acids include those that readily oxidize, e . g ., cysteine, methionine, and tryptophan.
  • buffers examples include, but are not limited to, citrate, histidine, succinate, phosphate, maleate, tris, acetate, carbohydrate, and gly-gly. Suitable buffers include citrate, histidine, succinate, and tris.
  • inorganic compounds that may be included in the particle formulation include, but are not limited to, NaCl, Na 2 SO 4 , NaHCO 3 , KCl, KH 2 PO 4 , CaCl 2 , and MgCl 2 .
  • the particle formulation may include other stabilizers/excipients, such as surfactants and salts.
  • surfactants include, but are not limited to, Polysorbate 20, Polysorbate 80, PLURONIC® (BASF Corporation, Mount Olive, N.J.) F68, and sodium dodecyl sulfate (SDS).
  • salts include, but are not limited to, sodium chloride, calcium chloride, and magnesium chloride.
  • the drug particle formulations comprise a drug.
  • the drug may be any physiologically or pharmacologically active substance, particularly those known to be delivered to the body of a human or an animal.
  • Suitable drugs include, but are not limited to: peptides, proteins, polypeptides or synthetic analogs of these species, as well as mixtures thereof.
  • preferred drugs include macromolecules.
  • macromolecules include, but are not limited to, pharmacologically active peptides, proteins, or polypeptides. Numerous peptides, proteins, or polypeptides that are useful in the practice of the present disclosure are described herein.
  • modifications of these peptides, proteins, or polypeptides are also known to one of skill in the art and can be used in the practice of the present disclosure following the guidance presented herein. Such modifications include, but are not limited to, amino acid analogs, amino acid mimetics, analog polypeptides, or derivative polypeptides.
  • the drugs disclosed herein may be formulated or administered singly or in combination ( e . g ., using mixtures of drugs or multiple devices; U.S. Patent Publication No. 2009/0202608 ).
  • Some embodiments of the present disclosure comprise use of polypeptides of SEQ ID NOs: 4-136, 138, 139 and 143-149.
  • Some embodiments of the present disclosure comprise use of a glucagon-receptor selective agonist polypeptide in combination with a second polypeptide, such as, by way of, non-limiting example, insulinotrophic peptides, peptide hormones, for example, glucagon and incretin mimetics ( e .
  • GLP-1 and exenatide as well as peptide analogs and peptide derivatives thereof;
  • PYY also known as peptide YY, peptide tyrosine tyrosine
  • peptide analogs and peptide derivatives thereof for example, PYY(3-36); oxyntomodulin, as well as peptide analogs and peptide derivatives thereof); and gastric inhibitory peptide (GIP), as well as peptide analogs and peptide derivatives thereof.
  • GIP gastric inhibitory peptide
  • GLP-1 including three forms of the peptide, GLP-1(1-37), GLP-1(7-37) and GLP-1(7-36) amide, as well as peptide analogs of GLP-1 have been shown to stimulate insulin secretion (i.e., is insulinotropic), which induces glucose uptake by cells and results in decreases in serum glucose concentrations ( see, e g., Mojsov, S., Int. J. Peptide Protein Research, 40:333-343 (1992 )).
  • GLP-1 peptide derivatives and peptide analogs demonstrating insulinotropic action are known in the art (see, e.g., U.S. Pat. Nos. 5,118,666 ; 5,120,712 ; 5,512,549 ; 5,545,618 ; 5,574,008 ; 5,574,008 ; 5,614,492 ; 5,958,909 ; 6,191,102 ; 6,268,343 ; 6,329,336 ; 6,451,974 ; 6,458,924 ; 6,514,500 ; 6,593,295 ; 6,703,359 ; 6,706,689 ; 6,720,407 ; 6,821,949 ; 6,849,708 ; 6,849,714 ; 6,887,470 ; 6,887,849 ; 6,903,186 ; 7,022,674 ; 7,041,646 ; 7,084,243 ; 7,101,843 ; 7,138,486 ; 7,141,547 ;
  • GLP-1 GLP-1 peptide derivative
  • Victoza® Novo Nordisk A/S, Bagsvaerd D K
  • Once-daily injectable Victoza® is commercially available in the United States, Europe, and Japan.
  • GLP-1 family of GLP-1 peptides, GLP-1 peptide derivatives and GLP-1 peptide analogs having insulinotropic activity
  • the molecule exenatide has the amino acid sequence of exendin-4 ( Kolterman O. G., et al., J. Clin. Endocrinol. Metab. 88(7):3082-9 (2003 )) and is produced by chemical synthesis or recombinant expression. Twice-daily injectable exenatide is commercially available in the United States and Europe, and sold under the trade name of Byetta® (Amylin Pharmaceuticals, Inc., San Diego, Calif.). Exendin-3 and exendin-4 are known in the art and were originally isolated from Heloderma spp. ( Eng, J., et al., J. Biol.
  • exendin-3 and exendin-4 for the treatment of type 2 diabetes mellitus and the prevention of hyperglycemia has been proposed (see, e.g., U.S. Pat. No. 5,424,286 ).
  • Numerous exenatide peptide derivatives and peptide analogs are known in the art (see, e.g., U.S. Pat. Nos.
  • exenatide derivative useful in the practice of the present disclosure is lixisenatide (also known as ZP10, AVE0010) (see, e.g., U.S. Pat. No. 6,528,486 ), which is in clinical trials.
  • lixisenatide also known as ZP10, AVE0010
  • ZP10 also known as ZP10, AVE0010
  • exenatide peptide derivatives e.g., including exendin-3, exendin-4, and exendin-4-amide
  • exenatide peptide derivatives e.g., including exendin-3, exendin-4, and exendin-4-amide
  • exenatide peptide derivatives e.g., including exenatide peptide derivatives
  • exenatide peptide analogs is referred to collectively as "exenatide.”
  • PYY is a 36 amino acid residue peptide amide. PYY inhibits gut motility and blood flow ( Laburthe, M., Trends Endocrinol Metab. 1(3):168-74 (1990 ), mediates intestinal secretion ( Cox, H. M., et al., Br J Pharmacol 101(2):247-52 (1990 ); Playford, R. J., et al., Lancet 335(8705):1555-7 (1990 )), and stimulate net absorption ( MacFayden, R. J., et al., Neuropeptides 7(3):219-27 (1986 )).
  • PYY(1-36) and PYY(3-36) Two major in vivo variants, PYY(1-36) and PYY(3-36), have been identified (e.g., Eberlein, G. A., et al., Peptides 10(4), 797-803 (1989 )).
  • the sequence of PYY, as well as peptide analogs and peptide derivatives thereof, are known in the art (e.g., U.S. Pat. Nos. 5,574,010 and 5,552,520 ).
  • Oxyntomodulin is a naturally occurring 37 amino acid peptide hormone found in the colon that has been found to suppress appetite and facilitate weight loss ( Wynne K, et al., Int J Obes (Lond) 30(12):1729-36(2006 )).
  • the sequence of oxyntomodulin, as well as peptide analogs and peptide derivatives thereof, are known in the art (e.g., Bataille D, et al., Peptides 2(Suppl 2):41-44 (1981 ); and U.S. Patent Publication Nos. 2005/0070469 and 2006/0094652 ).
  • GIP Gastric Inhibitory Peptide
  • Efendic S., et al., Horm Metab Res. 36:742-6 (2004 )
  • GIP circulates as a biologically active 42-amino acid peptide.
  • GIP is also known as glucose-dependent insulinotropic protein.
  • GIP is a 42-amino acid gastrointestinal regulatory peptide that stimulates insulin secretion from pancreatic beta cells in the presence of glucose ( Tseng, C., et al., PNAS 90:1992-1996 (1993 )).
  • Glucagon is a peptide hormone, produced by alpha cells of the pancreas, which raises the concentration of glucose in the bloodstream. Its effect is opposite that of insulin, which lowers the glucose concentration.
  • the pancreas releases glucagon when the concentration of glucose in the bloodstream falls too low.
  • Glucagon causes the liver to convert stored glycogen into glucose, which is released into the bloodstream. High blood glucose levels stimulate the release of insulin. Insulin allows glucose to be taken up and used by insulin-dependent tissues. Thus, glucagon and insulin are part of a feedback system that keeps blood glucose levels at a stable level.
  • Glucagon-like peptide-2 (GLP-2) is a 33 amino acid peptide with the sequence HADGSFSDEMNTILDNLAARDFINWLIQTKITD (SEQ ID NO: 200) in humans.
  • GLP-2 is created by specific post-translational proteolytic cleavage of proglucagon in a process that also liberates the related glucagon-like peptide-1 (GLP-1).
  • GLP-2 is produced by the intestinal endocrine L cell and by various neurons in the central nervous system. Intestinal GLP-2 is co-secreted along with GLP-1 upon nutrient ingestion. When externally administered, GLP-2 produces a number of effects in humans and rodents, including intestinal growth, enhancement of intestinal function, reduction in bone breakdown and neuroprotection. GLP-2 may act in an endocrine fashion to link intestinal growth and metabolism with nutrient intake.
  • Examples of half-lives of some of the peptides are as follows: exenatide, approximately 2.5 hours; GLP-1, approximately 2 minutes; GIP, approximately 5 minutes; PYY, approximately 8 minutes; glucagon, approximately 6 minutes; oxyntomodulin, approximately 6 minutes; and GLP-2, approximately 6 minutes.
  • the drugs can also be in various forms including, but not limited to, the following: uncharged molecules; components of molecular complexes; and pharmacologically acceptable salts such as hydrochloride, hydrobromide, sulfate, laurates, palmatates, phosphate, nitrate, borate, acetate, maleate, tartrate, oleates, or salicylates.
  • pharmacologically acceptable salts such as hydrochloride, hydrobromide, sulfate, laurates, palmatates, phosphate, nitrate, borate, acetate, maleate, tartrate, oleates, or salicylates.
  • salts of metals, amines or organic cations for example, quaternary ammonium
  • simple derivatives of the drug such as esters, ethers, amides and the like that have solubility characteristics suitable for the purpose of the disclosure can also be used herein.
  • the above drugs and other drugs known to those of skill in the art are useful in methods of treatment for a variety of conditions including but not limited to the following: chronic pain, hemophilia and other blood disorders, endocrine disorders, metabolic disorders, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), Alzheimer's disease, cardiovascular diseases (e.g., heart failure, atherosclerosis, and acute coronary syndrome), rheumatologic disorders, diabetes (including type 1, type 2 diabetes mellitus, human immunodeficiency virus treatment-induced, latent autoimmune diabetes in adults, and steroid-induced), hypoglycemia unawareness, restrictive lung disease, chronic obstructive pulmonary disease, lipoatrophy, metabolic syndrome, leukemia, hepatitis, renal failure, infectious diseases (including bacterial infection, viral infection (e.g., infection by human immunodeficiency virus, hepatitis C virus, hepatitis B virus, yellow fever virus, West Nile virus, Dengue virus,
  • some of the above agents are useful for the treatment of infectious diseases requiring chronic treatments including, but not limited to, tuberculosis, malaria, leishmaniasis, trypanosomiasis (sleeping sickness and Chagas disease), and parasitic worms.
  • the amount of drug in drug particle formulations is that amount necessary to deliver a therapeutically effective amount of the agent to achieve the desired therapeutic result in the subject to which the drug is being delivered. In practice, this will vary depending upon such variables, for example, as the particular agent, the severity of the condition, and the desired therapeutic effect.
  • Beneficial agents and their dosage unit amounts are known to the prior art in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11th Ed., (2005), McGraw Hill ; Remington's Pharmaceutical Sciences, 18th Ed., (1995), Mack Publishing Co. ; and Martin's Physical Pharmacy and Pharmaceutical Sciences, 1.00 edition (2005), Lippincott Williams & Wilkins . Further, highly concentrated drug particles are described in U.S. Patent Publication No. 2010/0092566 .
  • the volume of the chamber comprising the drug formulation is between about 100 ⁇ l to about 1000 ⁇ l, more preferably between about 140 ⁇ l and about 200 ⁇ l. In one embodiment, the volume of the chamber comprising the drug formulation is about 150 ⁇ l.
  • Drug particle formulations of the disclosure are preferably chemically and physically stable for at least 1 month, preferably at least 3 months, more preferably at least 6 months, more preferably at least 12 months at delivery temperature.
  • the delivery temperature is typically normal human body temperature, for example, about 37° C., or slightly higher, for example, about 40° C.
  • drug particle formulations of the present disclosure are preferably chemically and physically stable for at least 3 months, preferably at least 6 months, more preferably at least 12 months, at storage temperature.
  • Examples of storage temperatures include refrigeration temperature, for example, about 5° C.; or room temperature, for example, about 25° C.
  • a drug particle formulation may be considered chemically stable if less than about 25%; preferably less than about 20%, more preferably less than about 15%, more preferably less than about 10%, and more preferably less than about 5% breakdown products of the drug particles are formed after about 3 months, preferably after about 6 months, preferably after about 12 months at delivery temperature and after about 6 months, after about 12 months, and preferably after about 24 months at storage temperature.
  • a drug particle formulation may be considered physically stable if less than about 10%, preferably less than about 5%, more preferably less than about 3%, more preferably less than 1% aggregates of the drug are formed after about 3 months, preferably after about 6 months, at delivery temperature and about 6 months, preferably about 12 months, at storage temperature.
  • Tg glass transition temperature
  • the theory of formation of a high Tg amorphous solid to stabilize peptides, polypeptides, or proteins has been utilized in pharmaceutical industry.
  • Tg glass transition temperature
  • peptide products will not have mobility when stored at room temp or even at 40° C. because the storage temperature is below the Tg.
  • Tg is also dependent on the moisture concentration in the product formulation. Generally, the more moisture, the lower the Tg of the composition.
  • particle formulations are formable into particles using processes such as spray drying, lyophilization, desiccation, freeze-drying, milling, granulation, ultrasonic drop creation, crystallization, precipitation, or other techniques available in the art for forming particles from a mixture of components.
  • the particles are spray dried.
  • the particles are preferably substantially uniform in shape and size.
  • the particles are typically sized such that they can be delivered via an implantable osmotic delivery device. Uniform shape and size of the particles typically helps to provide a consistent and uniform rate of release from such a delivery device; however, a particle preparation having a non-normal particle size distribution profile may also be used.
  • the size of the particles is less than about 30%, more preferably is less than about 20%, more preferably is less than about than 10%, of the diameter of the delivery orifice.
  • particle sizes may be, for example, less than about 150 microns to about 50 microns. In an embodiment of the particle formulation for use with an osmotic delivery system, wherein the delivery orifice diameter of the implant is about 0.1 mm, particle sizes may be, for example, less than about 30 microns to about 10 microns. In one embodiment, the orifice is about 0.25 mm (250 microns) and the particle size is about 2 microns to about 5 microns.
  • Particles of a particle formulation have diameters of between about 2 microns to about 150 micron, e.g., less than 150 microns in diameter, less than 100 microns in diameter, less than 50 microns in diameter, less than 30 microns in diameter, less than 10 microns in diameter, less than 5 microns in diameter, and about 2 microns in diameter.
  • particles Preferably, particles have diameters of between about 2 microns and about 50 microns.
  • Particles of a particle formulation comprising an isolated glucagon-specific agonist polypeptide have average diameters of between about 0.3 microns to about 150 microns.
  • Particles of a particle formulation comprising an isolated glucagon-specific agonist polypeptide have average diameters of between about 2 microns to about 150 microns, e.g., less than 150 microns in average diameter, less than 100 microns in average diameter, less than 50 microns in average diameter, less than 30 microns in average diameter, less than 10 microns in average diameter, less than 5 microns in average diameter, and about 2 microns in average diameter.
  • particles have average diameters of between about 0.3 microns and 50 microns, for example, between about 2 microns and about 50 microns. In some embodiments, the particles have an average diameter between 0.3 microns and 50 microns, for example, between about 2 microns and about 50 microns, where each particle is less than about 50 microns in diameter.
  • the particles of the particle formulations when incorporated in a suspension vehicle, do not settle in less than about 3 months, preferably do not settle in less than about 6 months, more preferably do not settle in less than about 12 months, more preferably do not settle in less than about 24 months at delivery temperature, and most preferably do not settle in less than about 36 months at delivery temperature.
  • the suspension vehicles typically have a viscosity of between about 5,000 to about 30,000 poise, preferably between about 8,000 to about 25,000 poise, more preferably between about 10,000 to about 20,000 poise. In one embodiment, the suspension vehicle has a viscosity of about 15,000 poise, plus or minus about 3,000 poise. Generally speaking, smaller particles tend to have a lower settling rate in viscous suspension vehicles than larger particles.
  • micron- to nano-sized particles are typically desirable.
  • particles of about 2 microns to about 7 microns of the present disclosure will not settle for at least 20 years at room temperature based on simulation modeling studies.
  • the particle formulation of the present disclosure for use in an implantable osmotic delivery device, comprises particles of sizes less than about 50 microns, more preferably less than about 10 microns, more preferably in a range from about 2 microns to about 7 microns.
  • a drug particle formulation comprises a drug, as described above, one or more stabilizers, and optionally a buffer.
  • the stabilizers may be, for example, carbohydrate, antioxidant, amino acid, buffer, inorganic compound, or surfactant.
  • the amounts of stabilizers and buffer in the particle formulation can be determined experimentally based on the activities of the stabilizers and buffers and the desired characteristics of the formulation, in view of the teachings of the present specification.
  • the amount of carbohydrate in the formulation is determined by aggregation concerns. In general, the carbohydrate amount should not be too high so as to avoid promoting crystal growth in the presence of water due to excess carbohydrate unbound to drug.
  • the amount of antioxidant in the formulation is determined by oxidation concerns, while the amount of amino acid in the formulation is determined by oxidation concerns and/or formability of particles during spray drying.
  • the amount of buffer in the formulation is determined by pre-processing concerns, stability concerns, and formability of particles during spray drying. Buffer may be required to stabilize drug during processing, e.g ., solution preparation and spray drying, when all excipients are solubilized.
  • carbohydrates examples include, but are not limited to, monosaccharides (e.g ., fructose, maltose, galactose, glucose, D-mannose, and sorbose), disaccharides (e.g ., lactose, sucrose, trehalose, and cellobiose), polysaccharides ( e.g ., raffinose, melezitose, maltodextrins, dextrans, and starches), and alditols (acyclic polyols; e.g ., mannitol, xylitol, maltitol, lactitol, xylitol sorbitol, pyranosyl sorbitol, and myoinsitol).
  • Preferred carbohydrates include disaccharides and/or non-reducing sugars, such as sucrose, trehalose, and raffinose.
  • antioxidants examples include, but are not limited to, methionine, ascorbic acid, sodium thiosulfate, catalase, platinum, ethylenediaminetetraacetic acid (EDTA), citric acid, cysteine, thioglycerol, thioglycolic acid, thiosorbitol, butylated hydroxanisol, butylated hydroxyltoluene, and propyl gallate.
  • amino acids that readily oxidize can be used as antioxidants, for example, cysteine, methionine, and tryptophan.
  • amino acids examples include, but are not limited to, arginine, methionine, glycine, histidine, alanine, L-leucine, glutamic acid, iso-leucine, L-threonine, 2-phenylamine, valine, norvaline, praline, phenylalanine, tryptophan, serine, asparagines, cysteine, tyrosine, lysine, and norleucine.
  • buffers examples include, but are not limited to, citrate, histidine, succinate, phosphate, maleate, tris, acetate, carbohydrate, and gly-gly.
  • inorganic compounds that may be included in the particle formulation include, but are not limited to, NaCl, Na 2 SO 4 , NaHCO 3 , KCl, KH 2 PO 4 , CaCl 2 , and MgCl 2 .
  • the particle formulation may include other excipients, such as surfactants, and salts.
  • surfactants include, but are not limited to, Polysorbate 20, Polysorbate 80, PLURONIC® (BASF Corporation, Mount Olive, N.J.) F68, and sodium dodecyl sulfate (SDS).
  • salts include, but are not limited to, sodium chloride, calcium chloride, and magnesium chloride.
  • All components included in the particle formulation are typically acceptable for pharmaceutical use in mammals, particularly, in humans.
  • a selected drug or combination of drugs is formulated into dried powders in solid state, which preserve maximum chemical and biological stability of the drug.
  • the particle formulation offers long-term storage stability at high temperature, and therefore, allows delivery to a subject of stable and biologically effective drug for extended periods of time.
  • the suspension vehicle provides a stable environment in which the drug particle formulation is dispersed.
  • the drug particle formulations are chemically and physically stable (as described above) in the suspension vehicle.
  • the suspension vehicle typically comprises one or more polymer and one or more solvent that form a solution of sufficient viscosity to uniformly suspend the particles comprising the drug.
  • the suspension vehicle may comprise further components, including, but not limited to, surfactants, antioxidants, and/or other compounds soluble in the vehicle.
  • the viscosity of the suspension vehicle is typically sufficient to prevent the drug particle formulation from settling during storage and use in a method of delivery, for example, in an implantable, osmotic delivery device.
  • the suspension vehicle is biodegradable in that the suspension vehicle disintegrates or breaks down over a period of time in response to a biological environment, while the drug particle is dissolved in the biological environment and the active pharmaceutical ingredient ( i.e., the drug) in the particle is absorbed.
  • the suspension vehicle is a "single-phase" suspension vehicle, which is a solid, semisolid, or liquid homogeneous system that is physically and chemically uniform throughout.
  • the solvent in which the polymer is dissolved may affect characteristics of the suspension formulation, such as the behavior of drug particle formulation during storage.
  • a solvent may be selected in combination with a polymer so that the resulting suspension vehicle exhibits phase separation upon contact with the aqueous environment.
  • the solvent may be selected in combination with the polymer so that the resulting suspension vehicle exhibits phase separation upon contact with the aqueous environment having less than approximately about 10% water.
  • the solvent may be an acceptable solvent that is not miscible with water.
  • the solvent may also be selected so that the polymer is soluble in the solvent at high concentrations, such as at a polymer concentration of greater than about 30%.
  • solvents useful in the practice of the present disclosure include, but are not limited to, lauryl alcohol, benzyl benzoate, benzyl alcohol, lauryl lactate, decanol (also called decyl alcohol), ethyl hexyl lactate, and long chain (C 8 to C 24 ) aliphatic alcohols, esters, or mixtures thereof.
  • the solvent used in the suspension vehicle may be "dry," in that it has a low moisture content.
  • Preferred solvents for use in formulation of the suspension vehicle include lauryl lactate, lauryl alcohol, benzyl benzoate, and mixtures thereof.
  • polymers for formulation of the suspension vehicles of the present disclosure include, but are not limited to, a polyester (e.g ., polylactic acid and polylacticpolyglycolic acid), a polymer comprising pyrrolidones (e.g ., polyvinylpyrrolidone having a molecular weight ranging from approximately 2,000 to approximately 1,000,000), ester or ether of an unsaturated alcohol (e.g ., vinyl acetate), polyoxyethylenepolyoxypropylene block copolymer, or mixtures thereof.
  • Polyvinylpyrrolidone can be characterized by its K-value (e.g., K-17), which is a viscosity index.
  • the polymer is polyvinylpyrrolidone having a molecular weight of 2,000 to 1,000,000. In a preferred embodiment, the polymer is polyvinylpyrrolidone K-17 (typically having an approximate average molecular weight range of 7,900-10,800).
  • the polymer used in the suspension vehicle may include one or more different polymers or may include different grades of a single polymer. The polymer used in the suspension vehicle may also be dry or have a low moisture content.
  • a suspension vehicle for use in the present disclosure may vary in composition based on the desired performance characteristics.
  • the suspension vehicle may comprise about 40 wt % to about 80 wt % polymer(s) and about 20 wt % to about 60 wt % solvent(s).
  • Preferred embodiments of a suspension vehicle include vehicles formed of polymer(s) and solvent(s) combined at the following ratios: about 25 wt % solvent and about 75 wt % polymer; about 50 wt % solvent and about 50 wt % polymer; about 75 wt % solvent and about 25 wt % polymer.
  • the suspension vehicle may comprise selected components and in other embodiments consist essentially of selected components.
  • the suspension vehicle may exhibit Newtonian behavior.
  • the suspension vehicle is typically formulated to provide a viscosity that maintains a uniform dispersion of the particle formulation for a predetermined period of time. This helps facilitate making a suspension formulation tailored to provide controlled delivery of the drug contained in the drug particle formulation.
  • the viscosity of the suspension vehicle may vary depending on the desired application, the size and type of the particle formulation, and the loading of the particle formulation in the suspension vehicle.
  • the viscosity of the suspension vehicle may be varied by altering the type or relative amount of the solvent or polymer used.
  • the suspension vehicle may have a viscosity ranging from about 100 poise to about 1,000,000 poise, preferably from about 1,000 poise to about 100,000 poise.
  • the suspension vehicles typically have a viscosity, at 33° C., of between about 5,000 to about 30,000 poise, preferably between about 8,000 to about 25,000 poise, more preferably between about 10,000 to about 20,000 poise.
  • the suspension vehicle has a viscosity of about 15,000 poise, plus or minus about 3,000 poise, at 33° C. The viscosity may be measured at 33° C., at a shear rate of 10 -4 /sec, using a parallel plate rheometer.
  • the suspension vehicle may exhibit phase separation when contacted with the aqueous environment; however, typically the suspension vehicle exhibits substantially no phase separation as a function of temperature. For example, at a temperature ranging from approximately 0° C. to approximately 70° C. and upon temperature cycling, such as cycling from 4° C. to 37° C. to 4° C., the suspension vehicle typically exhibits no phase separation.
  • the suspension vehicle may be prepared by combining the polymer and the solvent under dry conditions, such as in a dry box.
  • the polymer and solvent may be combined at an elevated temperature, such as from approximately 40° C. to approximately 70° C., and allowed to liquefy and form the single phase.
  • the ingredients may be blended under vacuum to remove air bubbles produced from the dry ingredients.
  • the ingredients may be combined using a conventional mixer, such as a dual helix blade or similar mixer, set at a speed of approximately 40 rpm. However, higher speeds may also be used to mix the ingredients.
  • the suspension vehicle may be cooled to room temperature.
  • Differential scanning calorimetry (DSC) may be used to verify that the suspension vehicle is a single phase.
  • the components of the vehicle e.g., the solvent and/or the polymer
  • the drug particle formulation is added to the suspension vehicle to form a suspension formulation.
  • the suspension formulation may comprise a drug particle formulation and a suspension vehicle and in other embodiments consist essentially of a drug particle formulation and a suspension vehicle.
  • the suspension formulation may be prepared by dispersing the particle formulation in the suspension vehicle.
  • the suspension vehicle may be heated and the particle formulation added to the suspension vehicle under dry conditions.
  • the ingredients may be mixed under vacuum at an elevated temperature, such as from about 40° C. to about 70° C.
  • the ingredients may be mixed at a sufficient speed, such as from about 40 rpm to about 120 rpm, and for a sufficient amount of time, such as about 15 minutes, to achieve a uniform dispersion of the particle formulation in the suspension vehicle.
  • the mixer may be a dual helix blade or other suitable mixer.
  • the resulting mixture may be removed from the mixer, sealed in a dry container to prevent water from contaminating the suspension formulation, and allowed to cool to room temperature before further use, for example, loading into an implantable, drug delivery device, unit dose container, or multiple-dose container.
  • the suspension formulation typically has an overall moisture content of less than about 10 wt %, preferably less than about 5 wt %, and more preferably less than about 4 wt %.
  • the suspension formulations of the present disclosure are substantially homogeneous and flowable to provide delivery of the drug particle formulation from the osmotic delivery device to the subject.
  • the components of the suspension vehicle provide biocompatibility.
  • Components of the suspension vehicle offer suitable chemico-physical properties to form stable suspensions of drug particle formulations. These properties include, but are not limited to, the following: viscosity of the suspension; purity of the vehicle; residual moisture of the vehicle; density of the vehicle; compatibility with the dry powders; compatibility with implantable devices; molecular weight of the polymer; stability of the vehicle; and hydrophobicity and hydrophilicity of the vehicle. These properties can be manipulated and controlled, for example, by variation of the vehicle composition and manipulation of the ratio of components used in the suspension vehicle.
  • the suspension formulations described herein may be used in an implantable, osmotic delivery device to provide zero-order, continuous, controlled, and sustained delivery of a compound over an extended period of time, such as over weeks, months, or up to about one year or more.
  • an implantable osmotic delivery device is typically capable of delivering the suspension formulation, comprising the drug, at a desired flow rate over a desired period of time.
  • the suspension formulation may be loaded into the implantable, osmotic delivery device by conventional techniques.
  • a dose and delivery rate can be selected to achieve a desired blood concentration of a drug generally within less than about 6 half-lives of the drug within the subject after implantation of the device.
  • the blood concentration of the drug is selected to give the optimal therapeutic effects of the drug while avoiding undesirable side effects that may be induced by excess concentration of the drug, while at the same time avoiding peaks and troughs that may induce side effects associated with peak or trough plasma concentrations of the drug.
  • the implantable, osmotic delivery device typically includes a reservoir having at least one orifice through which the suspension formulation is delivered.
  • the suspension formulation may be stored within the reservoir.
  • the implantable, drug delivery device is an osmotic delivery device, wherein delivery of the drug is osmotically driven.
  • the osmotic delivery device typically consists of a cylindrical reservoir which contains the osmotic engine, piston, and drug formulation.
  • the reservoir is capped at one end by a controlled-rate, semi-permeable membrane and capped at the other end by a diffusion moderator through which suspension formulation, comprising the drug, is released from the drug reservoir.
  • the piston separates the drug formulation from the osmotic engine and utilizes a seal to prevent the water in the osmotic engine compartment from entering the drug reservoir.
  • the diffusion moderator is designed, in conjunction with the drug formulation, to prevent body fluid from entering the drug reservoir through the orifice.
  • the osmotic device releases a drug at a predetermined rate based on the principle of osmosis.
  • Extracellular fluid enters the osmotic delivery device through a semi-permeable membrane directly into a salt engine that expands to drive the piston at a slow and even delivery rate. Movement of the piston forces the drug formulation to be released through the orifice or exit port at a predetermined shear rate.
  • the reservoir of the osmotic device is loaded with a suspension formulation wherein the device is capable of delivering the suspension formulation to a subject over an extended period of time (e.g., about 1, about 3, about 6, about 9, about 10, and about 12 months) at a pre-determined, therapeutically effective delivery rate.
  • the release rate of the drug from the osmotic delivery device typically provides a subject with a predetermined target dose of a drug, for example, a therapeutically effective daily dose delivered over the course of a day; that is, the release rate of the drug from the device, provides substantial steady-state delivery of the drug at a therapeutic concentration to the subject.
  • a predetermined target dose of a drug for example, a therapeutically effective daily dose delivered over the course of a day; that is, the release rate of the drug from the device, provides substantial steady-state delivery of the drug at a therapeutic concentration to the subject.
  • the volume of a beneficial agent chamber comprising the beneficial agent formulation is between about 100 ⁇ l to about 1000 ⁇ l, more preferably between about 120 ⁇ l and about 500 ⁇ l, more preferably between about 150 ⁇ l and about 200 ⁇ l.
  • the osmotic delivery device is implanted within the subject, for example, subdermally or subcutaneously to provide subcutaneous drug delivery.
  • the device(s) can be implanted subdermally or subcutaneously into either or both arms (e.g., in the inside, outside, or back of the upper arm) or the abdomen. Preferred locations in the abdominal area are under the abdominal skin in the area extending below the ribs and above the belt line.
  • the abdominal wall can be divided into 4 quadrants as follows: the upper right quadrant extending at least 2-3 centimeters below the right ribs, e.g., at least about 5-8 centimeters below the right ribs, and at least 2-3 centimeters to the right of the midline, e.g., at least about 5-8 centimeters to the right of the midline; the lower right quadrant extending at least 2-3 centimeters above the belt line, e.g., at least about 5-8 centimeters above the belt line, and at least 2-3 centimeters to the right of the midline, e.g., at least about 5-8 centimeters to the right of the midline; the upper left quadrant extending at least 2-3 centimeters below the left ribs, e.g., at least about 5-8 centimeters below the left ribs, and at least 2-3 centimeters to the left of the
  • Termination of treatment by removal of an osmotic delivery device from a subject is straightforward, and provides the important advantage of immediate cessation of delivery of the drug to the subject.
  • the osmotic delivery device has a fail-safe mechanism to prevent an inadvertent excess or bolus delivery of drug in a theoretical situation like the plugging or clogging of the outlet (diffusion moderator) through which the drug formulation is delivered.
  • the osmotic delivery device is designed and constructed such that the pressure needed to partially or wholly dislodge or expel the diffusion moderator from the reservoir exceeds the pressure needed to partially or wholly dislodge or expel the semi-permeable membrane to the extent necessary to de-pressurize the reservoir.
  • suspension formulations may also be used in infusion pumps, for example, the ALZET® (DURECT Corporation, Cupertino, Calif.) osmotic pumps which are miniature, infusion pumps for the continuous dosing of laboratory animals (e.g., mice and rats).
  • ALZET® DURECT Corporation, Cupertino, Calif.
  • osmotic pumps which are miniature, infusion pumps for the continuous dosing of laboratory animals (e.g., mice and rats).
  • compositions used to practice the methods of the present invention meet the specifications for content and purity required of pharmaceutical products.
  • Glucagon polypeptides of the invention were synthesized on a Prelude peptide synthesizer (Protein Technologies Inc., Arlington, AZ) by solid-phase methods using Fmoc strategy with 2-(1 H-benzotriazole-1-yl)-1,1,3,3-tetramethyl uranium hexafluorophosphate (HBTU) or 2-(6-chloro-1 -H-benzotriazole- 1-yl)-1,1,3,3-tetramethylaminium hexafluorophosphate (HCTU) activation (5 fold molar excess) in N,N-dimethyiformamide (DMF), and N'N-Diisopropylethylamine (DIEA) as base, 20% piperidine/DMF for Fmoc deprotection.
  • HBTU 2-(1 H-benzotriazole-1-yl)-1,1,3,3-tetramethyl uranium hexafluorophosphate
  • the resin was Rink Amide MBHA LL (Novabiochem) or N- ⁇ -Fmoc protected, pre-loaded Wang LL (Novabiochem), with loadings of 0.29 - 0.35 mmol/g on a 20-400 ⁇ mol scale.
  • Final deprotection and cleavage of the peptide from the solid support was performed by treatment of the resin with (92.5% TFA, 2.5% phenol, 2.5% water and 2.5% triisopropylsilane) for 2-3 hours.
  • the cleaved peptide was precipitated using cold diethyl ether.
  • the diethyl ether was decanted and the solids triturated again with cold diethyl ether, pelleted by centrifugation and lyophilized.
  • the lyophilized solid was re-dissolved in a 1:1 solution of acetonitrile/water, with 0.1% TFA (10-15 mL), purified via reverse phase HPLC on a Waters XBridgeTM BEH 130, CIS, 10 pm, 130 ⁇ , 30 X 250 mm ID column, using a 30 gradient within the ranges of 5 - 75% acetonitrile/water with 0.1% TFA over 30 - 45 minutes at a flow rate of 30 mL/min, ⁇ - 215 nm.
  • the purified product was lyophilized and analyzed by ESI-LC/MS and analytical HPLC; and were demonstrated to be pure (>98%). Mass results all agreed with calculated values.
  • Characterizations of peptide analogs were performed via C18 HPLC and LC/MS analysis (Acquity SQD Waters Corp, Milford, MA) and UV detection provided by dual absorbance signals at 215 nm and 280 nm, using one of the three methods A or Method B or Method C.
  • Method A Performed using a Phenomenex UPLC AerisTM Peptide XB C18 35 column, 1.7 pm, 2.1 X 100 mm or ACQUiTY BEH300 or BEH130 CT8 column, 1.77 pm. 2.1 X 100 mm using 5 - 65% acetonitrile/water with 0.05% TFA over 30 minutes with a flow rate 0.5 mL/min, ⁇ - 215 nm, 280 nm.
  • Method B UPLC analysis was conducted on an Acquity BEH130, C18 column, 1.7 ⁇ m, 100 X 2.10 mm column at 25°C, 5 - 65% acetonitrile/water with 0.05% TFA over 20 minutes, flow rate 0.5 mL/min, ⁇ 215 nm, ⁇ 280 nm.
  • Method C UPLC analysis was conducted on an Acquity BEH130, C18 column, 1.7 ⁇ m, 100 X 2.10 mm column at 25°C, 5 - 65% acetonitrile/water with 0.05% TFA over 10 minutes, flow rate 0.5 mL/min, ⁇ 215 nm, ⁇ 280 nm. 5.0 uL of sample was injected using a PLNO (partial loop w/ needle overfill) injection mode.
  • PLNO partial loop w/ needle overfill
  • Table 3 provides the amino acid sequence and experimental data for the selective glucagon receptor analogs of the disclosure, including the selective glucagon receptor analogs referred to herein as Compound A4 (SEQ ID NO: 44), Compound A5 (SEQ ID NO: 45), Compound A6 (SEQ ID NO: 46), Compound A2 (SEQ ID NO: 42), Compound A1 (SEQ ID NO: 41), Compound A3 (SEQ ID NO: 43), Compound A97 (SEQ ID NO: 143), Compound A98 (SEQ ID NO: 144), Compound A99 (SEQ ID NO: 145), Compound A100 (SEQ ID NO: 146), Compound A101 (SEQ ID NO: 147), Compound A102 (SEQ ID NO: 148), and Compound A97 (SEQ ID NO: 149).
  • Compound A4 SEQ ID NO: 44
  • Compound A5 SEQ ID NO: 45
  • Compound A6 SEQ ID NO: 46
  • Compound A2 SEQ ID NO: 42
  • Glucagon polypeptides of the invention were synthesized on a Prelude peptide synthesizer (Protein Technologies Inc., Arlington, AZ)) by solid-phase methods using Fmoc strategy and using Rink Amide MBHA LL (Novabiochem) or N- ⁇ -Fmoc protected, pre-loaded Wang LL (Novabiochem), with loadings of 0.29 - 0.35 mmol/g on a 20-400 ⁇ mol scale.
  • Fmoc amino acid (4.0 eq, 1.0 mmol) residues were activated using 4.0 eq HBTU, 4.0 eq of HOBT, 8.0 eq DIEA and coupled to the resin for 1 hour.
  • the Fmoc group was removed by treatment with 20% (v/v) piperidine in dimethylformamide.
  • the side chain protection groups used were Trt for Asn, Gln, Cys and His; t-Bu for Ser, Thr, and Tyr; Boc for Lys and Trp; Ot-Bu for Asp and Glu; and Pbf for Arg.
  • Lactam Bridges between positions 17-21 and between positions 24-27 were introduced using an orthogonally protected Lysine (Alloc)17 and Glu (Allyl)21; and Glu(Allyl)24 and Lysine (Alloc)27 is represented by E in parenthesis in the sequence Lysine (Alloc) is represented by K in parenthesis in the sequences shown in SEQ ID NO: 19 and SEQ ID NO: 20.
  • the pellet was re-dissolved in water (10-15 mL), filtered purified by reverse phase HPLC on a Waters XBridgeTM BEH 130, CIS, 10 pm, 130 ⁇ , 30 X 250 mm ID column, using 30 a gradient within the ranges of 5 - 75% acetonitrile/water with 0.1% TFA over 30 - 45 minutes at a flow rate of 30 mL/min, ⁇ - 215 nm.
  • Characterizations of peptide analogs were performed via C18 HPLC and LC/MS analysis (Acquity SQD Waters Corp, Milford, MA) and UV detection provided by dual absorbance signals at 215 nm and 280 nm, using one of the three methods A or Method B or Method C.
  • Example 3 Stability and solubility of glucagon-receptor selective agonist polypeptides
  • Glucagon and the analogs described herein were tested for stability in saline 5% NaCl in water (i.e., bioassay buffer) or in aqueous (i.e., in water).
  • Glucagon and these analogs were incubated at 37°C and at room temperature. Samples were withdrawn at a regular interval for 30 days and analyzed by LC/MS and HPLC for determination of purity and mass of the degradation product. The results of this analysis are shown in Table 3.
  • Glucagon and the analogs described herein e.g. Compound A98, Compound A99, Compound A100, Compound A101, Compound A102, Compound A2, Compound A1, Compound A5, Compound A6, Compound A3, Compound A44, and Compound A97 were tested for solubility in saline 5% NaCl in water (i.e., bioassay buffer) or in aqueous at room temperature. Samples were visually inspected for clarity of the sample, any appearance of turbidity or haziness. The results of this analysis are shown in Table 3.
  • Example 4 In vitro screening of analogs, peptide-receptor mediated cAMP accumulation
  • CMV promoter-driven plasmids encoding human GCGR (NM_000160) and human GLP-1R (NM_002062) were transfected into CHO-K1 cells for 36 hours using Lipofectamine 2000. Following transfection, cells were removed from the flask using cell disruption media and dispensed in white 384-well plates at 1000 cells per well in 5 uL of stimulation buffer. Peptide-receptor activity was determined using the LANCE Ultra cAMP detection kit according to the manufacturer's protocol (Perkin Elmer). Peptides were serially diluted in stimulation buffer and 5 uL of each peptide dilution was added to cells and incubated for thirty minutes at room temperature.
  • tested concentrations ranged from 1 nM to 15 fM in the GCGR and GLP-1R assays.
  • tested concentrations ranged from 1 uM to 0.1 fM for GCGR, and 500 uM to 10 fM for GLP-1R assays.
  • 5 uL Europium labelled cAMP and 5 uL UlightTM anti-cAMP antibody were added to wells and incubated for an additional 60 minutes. Plates were read on an Envision® fluorescent plate reader and data was analyzed using GraphPad Prism®.
  • FIG. 1A demonstrates that peptides Compound A2, Compound A1 and glucagon are nearly equipotent on GCGR, while GLP-1 (7-37) activates GCGR at a much lower potency.
  • Figure 1B demonstrates that, in contrast to the results shown Figure 1A , peptides Compound A2 and Compound A1 are inactive on GLP-1R demonstrating that peptides Compound A2 and Compound A1 profile as GCGR selective agonists. Data of all the analogs are recorded in Table 3.
  • Example 5 Intravenous infusion: pharmacokinetic studies to assess peptide clearance from kidney (CL)
  • Example 6 Subcutaneous infusion: pharmacokinetic studies to assess peptide clearance from kidney (CL)
  • Plasma samples (approximately 250 uL) were collected for pharmacokinetic analysis via a jugular vein cannula at 1, 2, 3, 3.17, 3.33, 3.5, 4, 4.5, 5 and 6 h post-start of infusion into microtainer tubes containing K2EDTA as anticoagulant and 25 uL of a protease inhibitor cocktail. Plasma was prepared by centrifugation and stored at -80°C until analysis. The results of this analysis are shown below in Table 3 and in Figures 2A and 2B .
  • Example 7 Intravenous bolus injection: pharmacokinetic studies to assess peptide clearance from kidney (CL) cyclic peptide glucagon analogs
  • Compounds were formulated as solutions in either sterile saline, acidified saline (pH 2.0 or 4.5), or 5% DMSO in water and administered at a volume of 1.5 mL/kg and a final dose of 0.1 mg/kg.
  • Plasma samples (approximately 250 uL) were collected for pharmacokinetic analysis via a femoral vein cannula at 0.083, 0.167, 0.25, 0.33, 0.5, 1, 2, 4, 8, 12 and 24 h post-dose into microtainer tubes containing K2EDTA as anticoagulant and 25 uL of a protease inhibitor cocktail. Plasma was prepared by centrifugation and stored at -80°C until analysis. The results of this analysis are shown below in Table 4. Table 4. IV Bolus Clearance from Kidney (CL) Compound IV Bolus Clearance Kidney (CL) Glucagon 94.1 ⁇ 16.1 Compound A104 80.7 ⁇ 15.4 Compound A105 67.0 ⁇ 7.3
  • Example 8 Generic method of plasma sample preparation for pharmacokinetic studies
  • Plasma samples 75 uL were added to a 96-well plate containing 200 uL of 2:1 ethanol:acetonitrile containing 0.1% TFA and mixed well via aspiration. Plates were capped, vortex-mixed and centrifuged. Supernatants (215 uL) were transferred to a clean 96-well plate, evaporated to dryness under nitrogen flow and then reconstituted in 75 ⁇ L of 20% acetonitrile in water containing 0.1% formic acid.
  • Solid-Phase Extraction Samples were diluted 3-fold with 5% NH 4 OH (aq) and loaded onto an Oasis MAX microElution plate (Waters Corp, Milford, MA) that had been pre-conditioned with 200 uL each of methanol and 5% NH 4 OH (aq). The plate was washed with 200 uL 5% NH 4 OH (aq), followed by 200 uL 20% acetonitrile in water. Peptides were eluted using 200 uL 5% formic acid in methanol and evaporated under nitrogen flow. Samples were reconstituted in 80 uL 0.1% formic acid in water.
  • Example 10 In vivo efficacy of glucagon analogs with reduction in body weight
  • high fat chow Teklad TD 95217, 40%kcal from fat, Harlan Laboratories, Madison, WI. Rats were 15-17 weeks old at the start of the study. The rats were housed 1 per cage and given ad libitum access to high fat diet (Harlan TD.95217, 4.3
  • Example 11 Efficacy: body weight change in DIO rats after 13 days
  • cyclic peptide glucagon analogs were then used in combination with Exendin-4, a polypeptide comprising the amino acid sequence H-His-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile-Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH 2 (SEQ ID NO: 142).
  • Arterial samples were collected every 30 min into heparinized Natelson capillaries, the plasma separated on a bench-top centrifuge and then frozen at -20°C until assay.
  • Protease inhibitors were added to blood samples collected for GLP-1 measurement, which was assayed using Linco, Kit No. EGLP-35K.
  • Exenatide was assayed using a two-site sandwich assay.
  • GLP-1 Clearance of GLP-1 ranged from 34 ⁇ 4 to 38 ⁇ 3 mL/min, and was ⁇ 12-fold higher than that of exenatide.
  • the clearance of exenatide approximated the reported clearance of inulin (a marker of glomerular filtration rate).
  • the relationship between steady-state concentration and infusion rate expected for insulin is shown as a black dashed line.
  • Example 14 Steady state plasma concentrations and intravenous infusion rates for selected glucagon analogs
  • these data include those shown in the graph of Figure 5 , and additionally contain steady state concentrations (inverted triangles) of native glucagon when it was infused intravenously at 2 different infusion rates into anesthetized rats (using procedures described in Example 13).
  • the square data points, closest to GFR denote measured plasma concentrations of 2 glucagon analogs (Compounds A1 and A2) when they were administered continuously into the subcutaneous space via osmotic minipump.
  • the proximity of the square data points to the GFR dashed line indicates (a) that subcutaneous bioavailability was high, and that (b) clearance from the vascular compartment was consistent with being via glomerular filtration.
  • clearance was determined in numerous experiments performed as described above (for Example 14), except that intravenous infusion rate was uniformly 10 mcg/kg/hr. Selected values for clearance, expressed in mL/min per kg body weight, obtained such experiments, are provided in Table 5 below. Table 5. Row Selected Compound # CL mL/min/kg 1 A1 10.6 2 A2 10.8 3 A2 11.3 4 A1 11.5 5 A3 10.7 26 Glucagon 94
  • the three dark points at the top of the distribution, closest to GFR, are from rows 1, 2 and 5 in Table 5, corresponding to Compounds A1, A2 and A3.
  • Duplicate experiments in rows 3 and 4 returned values very similar to those in rows 1 and 2.
  • the solid line labelled GFR represents published values in rats.
  • the values from rows 1, 2 and 5 are close to this bound, consistent with these analogs being cleared from plasma via glomerular filtration.
  • the other dark point, on the dotted line labelled "glucagon,” farthest from GFR, represents the value obtained for native (human/rat) glucagon in this study.
  • Example 16 Comparison of dose dependency of weight loss in rats upon continuous administration of exenatide or a selected glucagon analog
  • the three curves denote the best-fitting 4-parameter sigmoid curves for each data set.
  • the fits were constrained to share the same percent change in weight for vehicle groups. Because all were working via a common (glucagon signaling) pathway, they were constrained to share a common maximal weight loss response, derived as 27.2% over 13 days.
  • ED50's were 51, 271 and 535 mcg/kg/day, respectively. Hill slopes were -1.43, -1.25 and -1.12, respectively.
  • the experiment demonstrates that even though each analog had been optimized for pharmacokinetic properties, in vivo potencies were different, and that it required experimentation to select the analog that had highest in vivo potency.
  • Example 18 Comparison of dose dependency of weight loss in rats upon continuous administration of a selected glucagon analog, alone or in combination with exenatide
  • Data on the graph of Figure 10 illustrate mean ( ⁇ SEM) percentage change in body weight of diet-induced obese rats over 27 days treatment.
  • Mean initial body weight was 564 ⁇ 4 g.
  • Compound A1 was delivered at rates of 0,7.5, 24 or 50 mcg/kg/day. There were, therefore, 2 dose-response experiments for Compound A1, one without, and one with exenatide.
  • the triangles denote the 27-day percent change in body weight in similarly-treated groups, but with exenatide at 10 mcg/kg/day added. This infusion on its own resulted in a 4.2% decrease in body weight, a relative difference from the vehicle-only group of 7.9%.
  • the squares represent the 7.9% loss expected of exenatide-only, added to the observed weight changes in the Compound A1-only groups, representing the arithmetic sum of responses of each component.
  • the dotted line is the fitted sigmoid curve through the arithmetically summed responses obtained by this method.
  • the expected response being the arithmetic sum of the responses of single agents
  • the observed responses of the combination of the 2 highest infusion rates of Compound A1 (24 and 50 mcg/kg/day) with exenatide gave weight loss that was greater than predicted. That is, there was a supra-additive (synergistic) effect.
  • the maximal weight loss response instead of being ⁇ 27%, was instead ⁇ 47%.
  • ZDF Male Zucker Diabetic Fatty rats were obtained 6 weeks of age (Charles River, Raleigh, NC) and used on study at 8 weeks old. Upon receipt, the rats were housed 1 per cage on alpha dri bedding (Shepherd Specialty Papers, Inc., Kalamazoo, MI) with free access to Purina 5008 chow (Lab Diet, St. Louis, MO) and water, maintained on a 12 hr light/dark cycle from 5:00 AM to 5:00 PM at 21° C and 50% relative humidity and allowed to acclimate for 9 days before the start of the study.
  • alpha dri bedding Shepherd Specialty Papers, Inc., Kalamazoo, MI
  • Purina 5008 chow Lab Diet, St. Louis, MO
  • water maintained on a 12 hr light/dark cycle from 5:00 AM to 5:00 PM at 21° C and 50% relative humidity and allowed to acclimate for 9 days before the start of the study.
  • the rats were dosed with exenatide (0.01 mg/kg/day in 10% DMSO/water) and/or a glucagon analog, compound A104, (0.03, 0.1, 0.3, 1.0 or 3.0 mg/kg/day in 10% DMSO/water) via subcutaneously (s.c.) placed Alzet osmotic pumps, model 2002 (DURECT Corporation, Cupertino, CA). Alzet pumps were filled under sterile condition with either vehicle (10% DMSO/sterile water) or exenatide on the day of surgery. Rats were anesthetized under isoflurane and the dorsal skin surface was shaved and cleansed with chlorhexidine and sterile water.
  • Rats were injected ID with Lidocaine (analgesic, 0.1 ml of 0.125% Lidocaine). A 1-2 cm surgical incision was made between the scapulae. Using blunt dissection, a 2-3 cm subcutaneous tunnel was created into which the sterile, filled, mini-osmotic pump was introduced. The skin opening was closed with a skin staple. Rats were monitored after surgery for their recovery from the isoflurane anesthesia.
  • Lidocaine analgesic, 0.1 ml of 0.125% Lidocaine
  • Blood samples were taken for baseline bleeds (day -3) via tail vein to measure triglyceride levels. Final blood samples were collected by cardiac puncture under isoflurane anesthesia (day 14). Serums were prepared according to manufacturer's protocol using EDTA and T-MG tubes, respectively [Terumo Medical Corporation, Elkton, MD]. After the terminal bleeds, livers were collected, weighed and homogenized for biochemical analysis ( Figure 13 ). Clinical chemistry analysis of serum samples and liver homogenate was performed by using an Olympus AU640 Clinical Chemistry analyzer (Olympus America Inc., Melville, NY) with the protocol and method parameters as described by the manufacturer for the triglyceride assay.
  • Olympus AU640 Clinical Chemistry analyzer Olympus America Inc., Melville, NY
  • the lipophilic substituent and spacer of Formula II was incorporated into numerous disclosed peptides: where the indicated carbonyl on the structure of Formula II was covalently joined to an ⁇ -amino group of a lysine residue of the disclosed peptide to form an amide linkage.
  • the linear peptide sequence was synthesized on a Prelude peptide synthesizer (Protein Technologies Inc., Arlington, AZ)) by solid-phase methods using Fmoc strategy with 2-(1H-benzotriazole-1-yl)-1,1,3,3-tetramethyl uranium hexafluorophosphate (HBTU) or 2-(6-chloro-1-H-benzotriazole-1-yl)-1,1,3,3-tetramethylaminium hexafluorophosphate (HCTU) activation (5 fold molar excess) in N,N-dimethyiformamide (DMF), and N'N-Diisopropylethylamine (DIEA) as base, 20% piperidine/DMF for Fmoc deprotection.
  • HBTU 2-(1H-benzotriazole-1-yl)-1,1,3,3-tetramethyl uranium hexafluorophosphate
  • HCTU 2-(
  • the resin was Rink Amide MBHA LL (Novabiochem) or N- ⁇ -Fmoc protected, pre-loaded Wang LL (Novabiochem), with loadings of 0.29 - 0.35 mmol/g on a 20-400 ⁇ mol scale.
  • FMOC-Lys(Alloc)-OH was preferentially substituted into the peptide chain.
  • Boc-Tyr(tbu)-OH or Boc-Trp(Boc)-OH was used as the N-terminal amino acid residue.
  • DCM Dichloromethane
  • the Alloc protecting group was removed using a solution of Palladium Tetrakis in (CHCl 3 /Acetic Acid/N-methylmorpholine, 37:2:1 ratio).
  • the resin was subsequently washed with a 0.5% solution of Sodium Diethyldithiocarbamate trihydrate in DMF, followed by a 0.5% solution of DIEA in DMF, and finally DMF.
  • FMOC-Glu(Otbu)-OH was coupled to the free Lysine side-chain using normal solid-phase conditions.
  • the C-16 acyl side-chain was added using Palmitic Acid under normal solid-phase methods.
  • the lyophilized solid was re-dissolved in a 1:1 solution of acetonitrile/water, with 0.1% TFA (10-15 mL), purified via reverse phase HPLC on a Waters XBridgeTM BEH 130, CI8, 10 um, 130 ⁇ , 30 X 250 mm ID column, using a gradient within the ranges of 5 - 75% acetonitrile/water with 0.1% TFA over 30 minutes at a flow rate of 30 mL/min, ⁇ - 215 nm. Column heater set at 60°C.
  • the purified product was lyophilized and analyzed by ESI-LC/MS and analytical HPLC; and were demonstrated to be pure (>98%). Mass results all agreed with calculated values.
  • HPLC analysis conditions 4.6 X 250mm XBridge BEH130, 5um, C18 column using an analytical Agilent 1100 with the following gradient: 20% to 100% over 15 minutes and holding at 100% to 20 minutes.
  • the column temperature was set at 40°C.
  • the flow rate was set at 1.0mL/min.
  • UV detection set at 215 and 280nm.
  • the lipophilic substituent and spacer of Formula III was incorporated into numerous disclosed peptides: where the indicated carbonyl on the structure of Formula III was covalently joined to an ⁇ -amino group of a lysine residue of the disclosed peptide to form an amide linkage.
  • the linear peptide sequence was synthesized on a Prelude peptide synthesizer (Protein Technologies Inc., Arlington, AZ)) by solid-phase methods using Fmoc strategy with 2-(1H-benzotriazole-1-yl)-1,1,3,3-tetramethyl uranium hexafluorophosphate (HBTU) or 2-(6-chloro-1-H-benzotriazole-1-yl)-1,1,3,3-tetramethylaminium hexafluorophosphate (HCTU) activation (5 fold molar excess) in N,N-dimethyiformamide (DMF), and N'N-Diisopropylethylamine (DIEA) as base, 20% piperidine/DMF for Fmoc deprotection.
  • HBTU 2-(1H-benzotriazole-1-yl)-1,1,3,3-tetramethyl uranium hexafluorophosphate
  • HCTU 2-(
  • the resin was Rink Amide MBHA LL (Novabiochem) or N- ⁇ -Fmoc protected, pre-loaded Wang LL (Novabiochem), with loadings of 0.29 - 0.35 mmol/g on a 20-400 ⁇ mol scale.
  • FMOC-Lys(Alloc)-OH was preferentially substituted into the peptide chain.
  • Boc-Tyr(tbu)-OH or Boc-Trp(Boc)-OH was used as the N-terminal amino acid residue.
  • DCM Dichloromethane
  • the Alloc protecting group was removed using a solution of Palladium Tetrakis in (CHCl 3 /Acetic Acid/N-methylmorpholine, 37:2:1 ratio).
  • the resin was subsequently washed with a 0.5% solution of Sodium Diethyldithiocarbamate trihydrate in DMF, followed by a 0.5% solution of DIEA in DMF, and finally DMF.
  • elongation of the spacer region proceeded with coupling of ⁇ 2-[2-(Fmoc-amino)ethoxy ⁇ acetic acid, followed by FMOC-Glu(Otbu)-OH using normal solid-phase conditions.
  • the C-18, acid terminating side-chain was added using Octadecanedioic Acid under normal solid-phase methods.
  • Final deprotection and cleavage of the peptide from the solid support was performed by treatment of the resin with (92.5% TFA, 2.5% phenol, 2.5% water and 2.5% triisopropylsilane) for 2-3 hours.
  • the cleaved peptide was precipitated using cold diethyl ether.
  • the diethyl ether was decanted and the solids triturated again with cold diethyl ether, pelleted by centrifugation and lyophilized.
  • the lyophilized solid was re-dissolved in a 1:1 solution of acetonitrile/water, with 0.1% TFA (10-15 mL), purified via reverse phase HPLC on a Waters XBridgeTM BEH 130, CI8, 10 um, 130 ⁇ , 30 X 250 mm ID column, using a gradient within the ranges of 5 - 75% acetonitrile/water with 0.1% TFA over 30 minutes at a flow rate of 30 mL/min, ⁇ - 215 nm. Column heater set at 60°C.
  • the purified product was lyophilized and analyzed by ESI-LC/MS and analytical HPLC; and were demonstrated to be pure (>98%). Mass results all agreed with calculated values.
  • HPLC analysis conditions 4.6 X 250mm XBridge BEH130, 5um, C18 column using an analytical Agilent 1100 with the following gradient: 5% to 70% over 15 minutes and holding at 70% to 20 minutes.
  • the column temperature was set at 40°C.
  • the flow rate was set at 1.5mL/min.
  • UV detection set at 215 and 280nm.
  • LCMS analysis conditions 4.6 X 250mm XBridge BEH130, 5um, C18 column using an analytical Agilent 1100 in combination with an API-4000 Sciex LC/MS/MS system with the following gradient: 5% to 65% over 10 minutes, ramping up to 95% to wash the column over 1 minute and equilibrating back to 5% organic to 12.5 minutes.
  • the column temperature was set at 40°C.
  • the flow rate was set at 1.5mL/min.
  • Each ⁇ -amino group of the lysine residue located at the indicated peptide residue (K****) in the disclosed compounds is covalently bound to the indicated carbonyl of the structure of Formula II to form an amide:
  • Each ⁇ -amino group of the lysine residue located at the indicated peptide residue (K*****) in the disclosed compounds is covalently bound to the indicated carbonyl of the structure of Formula III to form an amide:
  • Plasma samples (approximately 250 uL) were collected for pharmacokinetic analysis via a femoral vein cannula at 0, 0.25, 0.5, 1, 1.17, 1.33, 1.5, 2, 4, 6, 8, 24, 30 and 48 h post-start of infusion into microtainer tubes containing K2EDTA as anticoagulant and 25 uL of a protease inhibitor cocktail. Plasma was prepared by centrifugation and stored at -80°C until analysis. Representative results are provided in Table 8 below. Table 8.
  • Example 24 Weight Loss in Rats Upon Continuous Administration of Exenatide or a Glucagon Analog
  • the treatment groups comprised 30 different combinations of exenatide and glucagon analog, with 10-20 animals in each group.
  • Body weight was measured every 7 days. Results are illustrated in Figure 14 as a 3-D plot of weight loss on the vertical (Z) axis, represented as a percentage of initial body weight after 21 days of continuous dosing. A positive weight loss, shown as a circle atop a riser emerging from the base plane, thus represents a decrease in body weight relative to pre-treatment body weight. To maintain clarity, error bars are not shown.
  • the horizontal axes in Figure 14 relate to the logarithm of the daily dose in units of micrograms per kg body weight per day for each of the exenatide and glucagon analog singletons.
  • Log exenatide dose of -1 denotes treatments where exenatide dose was zero (glucagon analog-only treatments), and -1 on the glucagon log dose axis denotes treatments where glucagon was not dosed (exenatide-only treatments).
  • the series of points in the left foreground and in the right foreground therefore depict dose-responses for exenatide alone, and for the glucagon analog alone, respectively.
  • the weight loss response to exenatide alone after 21 days treatment could be described by a 4-parameter sigmoid curve with a maximal response of 12.5% weight loss, an ED 50 of 9.6 ⁇ g/kg/day, with a Hill slope of 0.88.
  • the parameters for 21 day weight loss were a maximum of 28.5%, an ED 50 of 45 ⁇ g/kg/day, and a Hill slope of 2.7.
  • the raw data in Figure 14 were fitted to a continuous function to enable characterization of certain key features of the response to exenatide/glucagon analog combinations.
  • the combination response was further constrained by a hyperbolic relationship such that it could not exceed 100% weight loss.
  • the symbols representing each treatment group are shown as spheres embedded within the mesh of the best-fitting surface in Figure 15 .
  • the 4 broken curves joining the exenatide-only and the glucagon analog-only planes represent lines of equal effect (isoboles) that would be obtained with an additive interaction as one agent was substituted for equi-effective doses of the other (expected 2%, 4%, 6% and 8% weight loss isoboles shown).
  • the 4 heavy solid lines depict what was instead observed, being the response surface corresponding to such dose-substitution.
  • the differences between the solid line (observed) and broken line (expected) define a synergistic interaction. For each level of predicted effect, there was a dose ratio where the effect peaked, and the synergy was maximal.
  • a combination product may comprise agents administered in a fixed ratio
  • the response surface was analyzed from the viewpoint of increasing doses of fixed-ratio mixtures.
  • the heavy black line where the gray plane of a fixed dose ratio intersects with the response surface, appears to transect the 4 gray lines near their dose-ratio optima.
  • the gray plane defines a 3:1 GGN:EX dose ratio. Mixtures of 10:1 and 1:1 GGN:EX also performed well.
  • the mixture with the highest apparent in vivo potency is most beneficial.
  • the apparent in vivo potency of different mixtures may be defined as effect per unit total mass of drug (or more strictly, per volume of formulation).
  • the responses to mixtures shown as surfaces in Figure 15 and Figure 16 may thereby be reduced to the 2-D dose responses shown in Figure 17 .
  • the X-axis in Figure 17 is not the dose of a single agent, but is the mass of both agents in a fixed-ratio mixture.
  • the family of dose responses for different mixtures includes one where the least combined dose evokes a given effect (exemplified by 20% weight loss, as indicated by the horizontal arrow).
  • a promising mixture thus identified was an approximately 3:1 mixture of GGN:EX.
  • the response to this mixture, exhibiting highest apparent potency, is shown as a broken line.

Claims (16)

  1. Isoliertes Polypeptid, das die folgende Aminosäuresequenz umfasst:
    X1X2X3GTFTSDX10X11X12X13LX15X16X17X18AQEFX23X24X25LEDE-Z-Schwanz (SEQ ID NO: 1), worin:
    X1 Y oder W ist;
    X2 S, G oder T ist;
    X3 Q oder H ist;
    X10 Y oder H ist;
    X11 S oder T ist;
    X12 K oder R ist;
    X13 Y, L oder W ist;
    X15 D oder E ist;
    X16 S, 2-Aminoisobuttersäure (Aib), A, E, L, Q, K oder I ist;
    X17 K, E, S, T oder A ist;
    X18 A, R, S, E, L, T oder Y ist;
    X23 T oder V ist;
    X24 K, I, L oder Aib ist;
    X25 H oder W ist; und
    Z-Schwanz fehlt; oder aus der Gruppe ausgewählt ist, die aus Folgendem besteht: EEPSSGAPPPS-OH (SEQ ID NO: 4); EPSSGAPPPS-OH (SEQ ID NO: 5); GAPPPS-OH (SEQ ID NO: 6); GGPSSGAPPPS-OH (SEQ ID NO: 7); GPSSGAPPPS-OH (SEQ ID NO: 8); KRNKNPPPS-OH (SEQ ID NO: 9); KRNKNPPS-OH (SEQ ID NO: 10); KRNKPPIA-OH (SEQ ID NO: 11); KRNKPPPA-OH (SEQ ID NO: 150); KRNKPPPS-OH (SEQ ID NO: 12); KSSGKPPPS-OH (SEQ ID NO: 13); PESGAPPPS-OH (SEQ ID NO: 14); PKSGAPPPS-OH (SEQ ID NO: 15); PKSKAPPPS-NH2(SEQ ID NO: 16); PKSKAPPPS-OH (SEQ ID NO: 17); PKSKEPPPS-NH2 (SEQ ID NO: 18); PKSKEPPPS-OH (SEQ ID NO: 19); PKSKQPPPS-OH (SEQ ID NO: 20); PKSKSPPPS-NH2 (SEQ ID NO: 21); PKSKSPPPS-OH (SEQ ID NO: 22); PRNKNNPPS-OH (SEQ ID NO: 23); PSKGAPPPS-OH (SEQ ID NO: 24); PSSGAPPPSE-OH (SEQ ID NO: 25); PSSGAPPPS-NH2 (SEQ ID NO: 26); PSSGAPPPS-OH (SEQ ID NO: 27); PSSGAPPPSS-OH (SEQ ID NO: 28); PSSGEPPPS-OH (SEQ ID NO: 29); PSSGKKPPS-OH (SEQ ID NO: 30); PSSGKPPPS-NH2 (SEQ ID NO: 31); PSSGKPPPS-OH (SEQ ID NO: 32); PSSGSPPPS-OH (SEQ ID NO: 33); PSSKAPPPS-OH (SEQ ID NO: 34); PSSKEPPPS-OH (SEQ ID NO: 35); PSSKGAPPPS-OH (SEQ ID NO: 36); PSSKQPPPS-OH (SEQ ID NO: 37); PSSKSPPPS-OH (SEQ ID NO: 38); SGAPPPS-OH (SEQ ID NO: 39); und SSGAPPPS-OH (SEQ ID NO: 40).
  2. Isoliertes Polypeptid nach Anspruch 1, das die folgende Aminosäuresequenz umfasst:
    X1X2X3GTFTSDX10X11X12X13LX15X16X17X18AQEFVX24WLEDE-Z-Schwanz (SEQ ID NO: 2), worin:
    X1 Y oder W ist;
    X2 S oder G ist;
    X3 Q oder H ist;
    X10 Y oder H ist;
    X11 S oder T ist;
    X12 K oder R ist;
    X13 Y, L oder W ist;
    X15 D oder E ist;
    X16 2-Aminoisobuttersäure (Aib), A oder S ist;
    X17 A oder K ist;
    X18 R, S, L oder Y ist;
    X24 K, I oder Aib ist; und
    Z-Schwanz fehlt oder aus der aus PSSGAPPPS-NH2 (SEQ ID NO: 26); PSSGAPPPS-OH (SEQ ID NO: 27); und PKSKSPPPS-NH2 (SEQ ID NO: 21) bestehenden Gruppe ausgewählt ist.
  3. Isoliertes Polypeptid nach Anspruch 1, das die folgende Aminosäuresequenz umfasst:
    YSX3GTFTSDYSKYLDX16X17X18AQEFVX24WLEDE-Z-Schwanz (SEQ ID NO: 3), worin:
    X3 Q oder H ist;
    X16 2-Aminoisobuttersäure (Aib) oder A ist;
    X17 A oder K ist;
    X18 R, S oder Y ist;
    X24 K oder Aib ist; und
    Z-Schwanz aus der aus PSSGAPPPS-OH (SEQ ID NO: 27) und PKSKSPPPS-NH2 (SEQ ID NO: 21) bestehenden Gruppe ausgewählt ist.
  4. Isoliertes Polypeptid nach Anspruch 3, das die Aminosäuresequenz SEQ ID NO: 41 umfasst oder aus dieser besteht (Verbindung A1).
  5. Isoliertes Polypeptid nach Anspruch 3, das die Aminosäuresequenz SEQ ID NO: 42 umfasst oder aus dieser besteht (Verbindung A2).
  6. Isoliertes Polypeptid, das die folgende Aminosäuresequenz umfasst:
    X1SX3GTFTSDX10SKYLDX16X17X18AQX21FVX24WLEDEPX31SX33X34PPPS-OH (SEQ ID NO: 151), worin:
    X1 Y oder W ist;
    X3 H oder Q ist;
    X10 Y, K oder K*** ist;
    X16 A, S, Aib, K oder K*** ist;
    X17 A, K, Aib oder K*** ist;
    X18 Y, S oder R ist;
    X21 E, K oder K*** ist;
    X24 I, Aib, K oder K*** ist;
    X31 S, K oder K*** ist;
    X33 G, K oder K*** ist; und
    X34 A oder S ist;
    worin K*** Lysin ist und die ε-Aminogruppe der Lysinseitenkette kovalent, gegebenenfalls über einen Spacer, an einen lipophilen Substituenten gebunden ist.
  7. Isoliertes Polypeptid nach Anspruch 6, wobei jeder lipophile Substituent kovalent über einen Spacer an das Peptid gebunden ist und wobei jeder lipophile Substituent und Spacer Formel II:
    Figure imgb0174
     oder Formel III entspricht:
    Figure imgb0175
  8. Isoliertes Polypeptid, das die folgende Aminosäuresequenz umfasst:
    YSQGTFTSDYSKYLDSX17RAQX21FVX24WLX27X28T-OH (SEQ ID NO: 137), worin:
    X17 K* ist, wobei sich K* in einer Lactambrücke mit E* an X21 befindet;
    X21 E* ist, wobei sich E* in einer Lactambrücke mit K* an X17 befindet;
    X24 K oder K** ist, wobei sich K** in einer Lactambrücke mit E** an X28 befindet;
    X27 Q oder D ist; und
    X28 E oder E** ist, wobei sich E** in einer Lactambrücke mit K** an X24 befindet, gegebenenfalls wobei das isolierte Polypeptid die Aminosäuresequenz von SEQ ID NO: 138 (Verbindung A104) oder SEQ ID NO: 139 (Verbindung A105) umfasst.
  9. Pharmazeutische Zusammensetzung, die ein isoliertes Polypeptid nach einem der vorangegangenen Ansprüche oder ein pharmazeutisch annehmbares Salz davon umfasst.
  10. Pharmazeutische Zusammensetzung nach Anspruch 9, die weiters ein zweites Polypeptid umfasst, das gegebenenfalls aus der folgenden Gruppe ausgewählt ist: Exenatid, einem Derivat von Exenatid, einem Analogon von Exenatid, glucagonähnlichem Peptid-1 (GLP-1), einem Derivat von GLP-1 und einem Analogon von GLP- 1.
  11. Teilchenformulierung, die ein isoliertes Polypeptid nach einem der Ansprüche 1 bis 8 oder eine pharmazeutische Zusammensetzung nach Anspruch 9 oder Anspruch 10 und zumindest eine stabilisierende Komponente umfasst, die gegebenenfalls aus der folgenden Gruppe ausgewählt ist: einem oder mehreren Kohlenhydraten, einem oder mehreren Antioxidantien, einer oder mehreren Aminosäuren, einem oder mehreren Puffern, einer oder mehreren anorganischen Verbindungen, einem oder mehreren Tensiden und Kombinationen daraus.
  12. Suspensionsformulierung, die eine Teilchenformulierung nach Anspruch 11 und ein Suspensionsvehikel umfasst, wobei das Suspensionsvehikel gegebenenfalls ein oder mehrere Polymere und ein oder mehrere Lösungsmittel umfasst.
  13. Osmotische Abgabevorrichtung, die ein isoliertes Polypeptid nach einem der Ansprüche 1 bis 8, eine pharmazeutische Zusammensetzung nach Anspruch 9 oder Anspruch 10, eine Teilchenformulierung nach Anspruch 11 oder eine Suspensionsformulierung nach Anspruch 12 umfasst.
  14. Osmotische Abgabevorrichtung nach Anspruch 13, die weiters Folgendes umfasst:
    einen undurchlässigen Behälter, der Innen- und Außenflächen und ein erstes und zweites offenes Ende umfasst,
    eine halbdurchlässige Membran, die mit dem ersten offenen Ende des Behälters in abdichtender Beziehung steht,
    einen osmotischen Motor innerhalb des Behälters und benachbart zur halbdurchlässigen Membran,
    einen Kolben benachbart zum osmotischen Motor, wobei der Kolben eine bewegbare Dichtung mit der Innenfläche des Behälters bildet, der Kolben den Behälter in eine erste Kammer und eine zweite Kammer teilt, wobei die erste Kammer den osmotischen Motor umfasst,
    eine Suspensionsformulierung, wobei die zweite Kammer die Suspensionsformulierung umfasst und die Suspensionsformulierung fließfähig ist und das isolierte Polypeptid umfasst, und
    einen Diffusionsmoderator, der in das zweite offene Ende des Behälters eingesetzt ist, wobei der Diffusionsmoderator benachbart zur Suspensionsformulierung angeordnet ist.
  15. Isoliertes Polypeptid nach einem der Ansprüche 1 bis 8, pharmazeutische Zusammensetzung nach Anspruch 9 oder Anspruch 10, Teilchenformulierung nach Anspruch 11 oder Suspensionsformulierung nach Anspruch 12 zur Verwendung in einem Verfahren zur Behandlung oder Linderung eines Symptoms einer Krankheit oder Störung, die mit einer anormalen Glucagonaktivität assoziiert wird, beispielsweise Diabetes mellitus Typ 2, bei einem Individuum, das diese benötigt.
  16. Isoliertes Polypeptid nach einem der Ansprüche 1 bis 8, pharmazeutische Zusammensetzung nach Anspruch 9 oder Anspruch 10, Teilchenformulierung nach Anspruch 11 oder Suspensionsformulierung nach Anspruch 12 zur Verwendung in einem Verfahren zur
    (i) Behandlung einer metabolischen Erkrankung oder Störung, die mit erhöhter Blutglucose assoziiert ist,
    (ii) Behandlung, Verzögerung des Eintretens, Verzögerung des Fortschreitens oder anderweitige Verbesserung eines Symptoms einer Krankheit oder Störung, bei der ein Co-Agonismus an sowohl dem Glucagon- als auch dem GLP-1-Rezeptor gewünscht wird, oder
    (iii) Behandlung von Adipositas.
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